Provider Demographics
NPI:1831074707
Name:WAKEFIELD HAGAN, DEANA (LCSW)
Entity type:Individual
Prefix:
First Name:DEANA
Middle Name:
Last Name:WAKEFIELD HAGAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DEANA
Other - Middle Name:
Other - Last Name:WAKEFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1107 LORA ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31410-1820
Mailing Address - Country:US
Mailing Address - Phone:912-656-1770
Mailing Address - Fax:912-350-0761
Practice Address - Street 1:1107 LORA ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31410-1820
Practice Address - Country:US
Practice Address - Phone:912-656-1770
Practice Address - Fax:912-350-0761
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0032661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty