Provider Demographics
NPI:1407257728
Name:PAXTON, SCHUYLER
Entity Type:Individual
Prefix:
First Name:SCHUYLER
Middle Name:
Last Name:PAXTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 S 7TH ST STE C
Mailing Address - Street 2:
Mailing Address - City:ADEL
Mailing Address - State:IA
Mailing Address - Zip Code:50003-1838
Mailing Address - Country:US
Mailing Address - Phone:515-993-1919
Mailing Address - Fax:515-993-1922
Practice Address - Street 1:309 S 7TH ST STE C
Practice Address - Street 2:
Practice Address - City:ADEL
Practice Address - State:IA
Practice Address - Zip Code:50003-1838
Practice Address - Country:US
Practice Address - Phone:515-993-1919
Practice Address - Fax:515-993-1922
Is Sole Proprietor?:No
Enumeration Date:2014-09-05
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0014375101YM0800X
IA98166101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health