Basic Information
| Provider Information | |||||||||
| NPI: | 1073284782 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SAXTON | ||||||||
| FirstName: | NICHOLAS | ||||||||
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| Credential: | LSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 26101 COUNTRY CLUB BLVD APT 1325 | ||||||||
| Address2: | |||||||||
| City: | NORTH OLMSTED | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440704548 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4402252712 | ||||||||
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| Practice Location | |||||||||
| Address1: | 807 E WASHINGTON ST STE 150 | ||||||||
| Address2: | |||||||||
| City: | MEDINA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 442563339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3302414444 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2021 | ||||||||
| LastUpdateDate: | 09/22/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041S0200X | S.2106790 | OH | Y | Behavioral Health & Social Service Providers | Social Worker | School |
No ID Information.