Provider Demographics
NPI:1023057205
Name:SAXE, ELLEN (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:SAXE
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 ASHFIELD ST
Mailing Address - Street 2:
Mailing Address - City:SHELBURNE FALLS
Mailing Address - State:MA
Mailing Address - Zip Code:01370-1414
Mailing Address - Country:US
Mailing Address - Phone:413-585-8785
Mailing Address - Fax:
Practice Address - Street 1:94 KING ST
Practice Address - Street 2:SUITE 3A
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3284
Practice Address - Country:US
Practice Address - Phone:413-585-8785
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1111261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP04720OtherBCBS