Provider Demographics
NPI:1689712085
Name:SAVAGE, TIA HOLT (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:TIA
Middle Name:HOLT
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 628
Mailing Address - Street 2:
Mailing Address - City:NORTH SUTTON
Mailing Address - State:NH
Mailing Address - Zip Code:03260-0622
Mailing Address - Country:US
Mailing Address - Phone:978-314-4519
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 628
Practice Address - Street 2:
Practice Address - City:NORTH SUTTON
Practice Address - State:NH
Practice Address - Zip Code:03260-0622
Practice Address - Country:US
Practice Address - Phone:978-314-4519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH27871041C0700X
VT089.01357481041C0700X
MA1149981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical