Individual provider Active NPI

Savanna Kay Cardona, LLMSW

  • Clinical Social Worker
  • Wyandotte, MI
National Provider Identifier
1912419193
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6851118922 Issued in MI
Practice address
100 Maple St Ste 215
Wyandotte, MI 48192-5966
Phone
(734) 361-1416
Fax
(734) 245-8462
NPI assigned
Oct 28, 2017
Last updated
Nov 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6851118922 MI Primary

Addresses

Primary practice location

100 Maple St Ste 215
Wyandotte, MI 48192-5966

Mailing address

100 Maple St Ste 215
Wyandotte, MI 48192-5966
Phone (734) 361-1416

Other names 1

  • Savanna Mowl Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6851118922MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1509148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1912419193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MAPLE ST STE 215",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481925966",
            "telephone_number": "734-361-1416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MAPLE ST STE 215",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481925966",
            "telephone_number": "734-361-1416",
            "fax_number": "734-245-8462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDONA",
        "first_name": "SAVANNA",
        "middle_name": "KAY",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-28",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851118922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAVANNA",
            "last_name": "MOWL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wyandotte, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.