Provider Demographics
NPI:1447872379
Name:BURKE, SAVANNAH LEIGH
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:LEIGH
Last Name:BURKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SAVANNAH
Other - Middle Name:L
Other - Last Name:CAYTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5857
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77325-5857
Mailing Address - Country:US
Mailing Address - Phone:832-233-3086
Mailing Address - Fax:832-415-3050
Practice Address - Street 1:2323 TIMBER SHADOWS DR STE B
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2028
Practice Address - Country:US
Practice Address - Phone:832-233-3086
Practice Address - Fax:832-415-3050
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-13
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80952101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80952OtherTEXAS STATE BOARD OF PROFESSIONAL COUNSELORS