Provider Demographics
NPI:1932954070
Name:PAXTON, HALSY E
Entity Type:Individual
Prefix:
First Name:HALSY
Middle Name:E
Last Name:PAXTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5615 DUBLINSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-2419
Mailing Address - Country:US
Mailing Address - Phone:419-571-7382
Mailing Address - Fax:
Practice Address - Street 1:6209 RIVERSIDE DR STE 200A
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-6028
Practice Address - Country:US
Practice Address - Phone:419-571-7382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2202816-TRNE104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty