Healthcare Provider Details

I. General information

NPI: 1598057747
Provider Name (Legal Business Name): SARA LYNNE THAXTON PHD, LPC, EMDR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2011
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 S MAIN AVE
SCRANTON PA
18504-2545
US

IV. Provider business mailing address

228 S MAIN AVE
SCRANTON PA
18504-2545
US

V. Phone/Fax

Practice location:
  • Phone: 570-904-7363
  • Fax: 570-227-1591
Mailing address:
  • Phone: 570-904-7363
  • Fax: 570-227-1591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1598057747
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerNPI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: