Provider Demographics
NPI:1760226864
Name:MAKOWSKI, SAVANNAH DAWN (LMSW)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:DAWN
Last Name:MAKOWSKI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3405 PEACH ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30906-5168
Mailing Address - Country:US
Mailing Address - Phone:706-832-8165
Mailing Address - Fax:
Practice Address - Street 1:4434 COLUMBIA RD STE 205
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-4281
Practice Address - Country:US
Practice Address - Phone:706-910-0538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-24
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17014104100000X
GAMSW012195104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker