MEDICARE: MRS. FRANCES VALERIE SAXENBERG LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW 5917	FL

General Provider Information

NPI Number	:	1376524934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. FRANCES VALERIE SAXENBERG LCSW

Provider Business Mailing Address
First Line	:	1056 RIDGEWOOD LN
Second Line	:
City	:	SAINT AUGUSTINE
State	:	FL
Zip	:	32086-3230
Country	:	US
Telephone Number	:	904-229-7955
Fax Number	:	904-797-0633

Provider Business Practice Location Address
First Line	:	1056 RIDGEWOOD LN
Second Line	:
City	:	SAINT AUGUSTINE
State	:	FL
Zip	:	32086-3230
Country	:	US
Telephone Number	:	904-229-7955
Fax Number	:	904-223-4052

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	11/17/2017

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