Provider Demographics
NPI:1679872527
Name:CAROL SAVAGE LLC
Entity type:Organization
Organization Name:CAROL SAVAGE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:SAVAGE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:407-402-6717
Mailing Address - Street 1:PO BOX 952464
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32795-2464
Mailing Address - Country:US
Mailing Address - Phone:407-402-6717
Mailing Address - Fax:407-880-4344
Practice Address - Street 1:310 WAYMONT CT
Practice Address - Street 2:SUITE 104
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3475
Practice Address - Country:US
Practice Address - Phone:407-402-6717
Practice Address - Fax:407-880-4344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-17
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10583101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty