Healthcare Provider Details

I. General information

NPI: 1306215124
Provider Name (Legal Business Name): DAVID SAXEY LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2015
Last Update Date: 09/28/2020
Certification Date: 09/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7950 HORSESHOE BEND RD STE 104
BOISE ID
83714-3809
US

IV. Provider business mailing address

1751 S HERITAGE AVE
BOISE ID
83709-2267
US

V. Phone/Fax

Practice location:
  • Phone: 541-519-1654
  • Fax: 209-908-6164
Mailing address:
  • Phone: 541-519-1654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-7869
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: