Healthcare Provider Details

I. General information

NPI: 1558655019
Provider Name (Legal Business Name): KATINA B SAXTON LCSW-R
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATINA B LITTLE

II. Dates (important events)

Enumeration Date: 06/01/2011
Last Update Date: 08/17/2021
Certification Date: 08/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

939 ROUTE 146 STE 610
CLIFTON PARK NY
12065-3662
US

IV. Provider business mailing address

939 ROUTE 146 STE 610
CLIFTON PARK NY
12065-3662
US

V. Phone/Fax

Practice location:
  • Phone: 518-201-2789
  • Fax: 518-201-2750
Mailing address:
  • Phone: 518-201-2789
  • Fax: 518-201-2750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number079939-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number084165
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: