Provider Demographics
NPI:1386685659
Name:PAXTON, RAYMOND DEAN (LCSW)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:DEAN
Last Name:PAXTON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:800 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-5275
Mailing Address - Country:US
Mailing Address - Phone:573-814-6000
Mailing Address - Fax:573-814-6493
Practice Address - Street 1:196 STONEBRIDGE DR
Practice Address - Street 2:UNIT B5
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29588-6187
Practice Address - Country:US
Practice Address - Phone:843-353-9976
Practice Address - Fax:843-443-4229
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2017-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20020131251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical