Provider Demographics
NPI:1053808691
Name:COE, SAVANNAH CALLIE (LCSW)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:CALLIE
Last Name:COE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SAVANNAH
Other - Middle Name:CALLIE
Other - Last Name:REEP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:12921 CANTRELL RD STE 105
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-1798
Mailing Address - Country:US
Mailing Address - Phone:501-891-5492
Mailing Address - Fax:
Practice Address - Street 1:12921 CANTRELL RD STE 105
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-1798
Practice Address - Country:US
Practice Address - Phone:501-891-5492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-19
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR9613-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical