Savannah Lord

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

097.0134395 Issued in VT

Practice address

148 College St Ste 204a
Burlington, VT 05401-8476

Phone

(207) 812-6070

NPI assigned

Dec 31, 2020

Last updated

Dec 31, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 24, 2025 through Jul 24, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Revolution Youth Inc

  • Community/Behavioral Health Agency
  • Burlington, VT
  • NPI 1619638905
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1609372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1861080210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 BACON ST UNIT 210",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054034494",
            "telephone_number": "207-812-6070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 COLLEGE ST STE 204A",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054018476",
            "telephone_number": "207-812-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORD",
        "first_name": "SAVANNAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-31",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "097.0134395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lonestar Mental Health
• Jennifer Long
• Kate Jessamyn Longmaid, PH.D.
• Ivyrose Marie Lopez, CPM
• Miranda Paige Lopez, MS, RDN, CDN
• Samuel Loren, MD
• Lisa Lorenz, LCPC
• Rachel Conover Loreto, LMSW
• Malvina Vasiliki Maria Lorida
• Shira R. Louria, PSY.D.

• Clinical Social Worker in Burlington, VT
• Providers in Burlington, VT by specialty
• Clinical Social Worker in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.