Provider Demographics
NPI:1942587993
Name:PAXTON, CORWIN GLENN (LPC)
Entity Type:Individual
Prefix:
First Name:CORWIN
Middle Name:GLENN
Last Name:PAXTON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2005 STOCKBRIDGE RD
Mailing Address - Street 2:4205
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76208-6143
Mailing Address - Country:US
Mailing Address - Phone:214-604-9155
Mailing Address - Fax:
Practice Address - Street 1:860 HEBRON PKWY
Practice Address - Street 2:SUITE 1102
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-5151
Practice Address - Country:US
Practice Address - Phone:214-604-9155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68456101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional