Provider Demographics
NPI:1053012070
Name:LEE, SAVANNAH BURDICK (LMSW)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:BURDICK
Last Name:LEE
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 1:274 N GOODMAN ST STE A300
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-1171
Mailing Address - Country:US
Mailing Address - Phone:585-206-2631
Mailing Address - Fax:585-206-1006
Practice Address - Street 1:274 N GOODMAN ST STE A300
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-1171
Practice Address - Country:US
Practice Address - Phone:585-206-2631
Practice Address - Fax:585-206-1006
Is Sole Proprietor?:No
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY119252101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health