Healthcare Provider Details

I. General information

NPI: 1477975985
Provider Name (Legal Business Name): TRICIA SAXTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2014
Last Update Date: 10/27/2021
Certification Date: 10/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 ORISKANY BLVD
WHITESBORO NY
13492-1323
US

IV. Provider business mailing address

5769 CHEESE FACTORY RD
MANLIUS NY
13104-9636
US

V. Phone/Fax

Practice location:
  • Phone: 315-266-3100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number087606
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number082730
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: