Healthcare Provider Details

I. General information

NPI: 1023057205
Provider Name (Legal Business Name): ELLEN SAXE MSW, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 KING ST SUITE 3A
NORTHAMPTON MA
01060-3284
US

IV. Provider business mailing address

70 ASHFIELD ST
SHELBURNE FALLS MA
01370-1414
US

V. Phone/Fax

Practice location:
  • Phone: 413-585-8785
  • Fax:
Mailing address:
  • Phone: 413-585-8785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number111126
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: