Provider Demographics
NPI:1447949607
Name:MORIN, SAVANNAH MARTHA (LAC, NCC)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:MARTHA
Last Name:MORIN
Suffix:
Gender:F
Credentials:LAC, NCC
Other - Prefix:
Other - First Name:SAVANNAH
Other - Middle Name:
Other - Last Name:BOWEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4520 N CENTRAL AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-1831
Mailing Address - Country:US
Mailing Address - Phone:602-424-2060
Mailing Address - Fax:
Practice Address - Street 1:4520 N CENTRAL AVE STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-1831
Practice Address - Country:US
Practice Address - Phone:602-424-2060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-03
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-21928101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor