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General NPI Number Information
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NPI Number | 1073284782
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Entity Type | Individual
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Provider Name | NICHOLAS SAXTON LSW
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Gender | Male
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Dates
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Enumeration Date | 09/22/2021
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Last Update Date | 09/22/2021
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Provider Practice Location Address
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Address Line | 807 E WASHINGTON ST STE 150
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City | MEDINA
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State | OH
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Zip | 44256-3339
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Country | US
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Telephone | 330-241-4444
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Fax |
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Provider Business Mailing Address
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Address Line | 26101 COUNTRY CLUB BLVD APT 1325
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City | NORTH OLMSTED
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State | OH
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Zip | 44070-4548
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Country | US
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Telephone | 440-225-2712
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | S.2106790
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License Number State | OH
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