Basic Information
| Provider Information | |||||||||
| NPI: | 1538513239 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SAVAGE | ||||||||
| FirstName: | APRIL | ||||||||
| MiddleName: | NICOLE | ||||||||
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| Credential: | LCAS,LCSW-A, LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 152 TUGGIE EURE RD | ||||||||
| Address2: | |||||||||
| City: | EURE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 279359681 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2522875600 | ||||||||
| FaxNumber: | 2523570797 | ||||||||
| Practice Location | |||||||||
| Address1: | 733 2ND AVENUE | ||||||||
| Address2: | |||||||||
| City: | KOTZEBUE | ||||||||
| State: | AK | ||||||||
| PostalCode: | 99752 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9074427640 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2016 | ||||||||
| LastUpdateDate: | 01/03/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 22210 | NC | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 1041C0700X | C011311 | NC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.