Provider Demographics
NPI:1093386674
Name:SAXTON, IRENE SARAH (LMSW)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:SARAH
Last Name:SAXTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 CITYVIEW AVE # 1
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:AK
Mailing Address - Zip Code:99603-7040
Mailing Address - Country:US
Mailing Address - Phone:907-235-2102
Mailing Address - Fax:
Practice Address - Street 1:195 CITYVIEW AVE # 1
Practice Address - Street 2:
Practice Address - City:HOMER
Practice Address - State:AK
Practice Address - Zip Code:99603-7040
Practice Address - Country:US
Practice Address - Phone:907-235-2102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-06
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK172445104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker