Healthcare Provider Details

I. General information

NPI: 1376524934
Provider Name (Legal Business Name): FRANCES VALERIE SAXENBERG LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 11/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1056 RIDGEWOOD LN
SAINT AUGUSTINE FL
32086-3230
US

IV. Provider business mailing address

1056 RIDGEWOOD LN
SAINT AUGUSTINE FL
32086-3230
US

V. Phone/Fax

Practice location:
  • Phone: 904-229-7955
  • Fax: 904-223-4052
Mailing address:
  • Phone: 904-229-7955
  • Fax: 904-797-0633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW 5917
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: