Provider Demographics
NPI:1558978585
Name:SEXTON, SALVATORE (CASAC ADV COUNSELOR)
Entity Type:Individual
Prefix:
First Name:SALVATORE
Middle Name:
Last Name:SEXTON
Suffix:
Gender:M
Credentials:CASAC ADV COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-2841
Mailing Address - Country:US
Mailing Address - Phone:631-574-8236
Mailing Address - Fax:
Practice Address - Street 1:212 W MAIN ST
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-2841
Practice Address - Country:US
Practice Address - Phone:631-574-8236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)