Provider Demographics
NPI:1356008163
Name:SAXON, VINCENT HONEYBEE
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:HONEYBEE
Last Name:SAXON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:DARLENE KAY
Other - Last Name:SAXON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2696 TOWER RD
Mailing Address - Street 2:
Mailing Address - City:MCFARLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53558-9280
Mailing Address - Country:US
Mailing Address - Phone:608-354-8569
Mailing Address - Fax:
Practice Address - Street 1:2696 TOWER RD
Practice Address - Street 2:
Practice Address - City:MCFARLAND
Practice Address - State:WI
Practice Address - Zip Code:53558
Practice Address - Country:US
Practice Address - Phone:608-354-8569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-29
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11615-1231041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical