Provider Demographics
NPI:1386315315
Name:SAXTON, KYLE EDWARD (LCSW, CASAC)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:EDWARD
Last Name:SAXTON
Suffix:
Gender:M
Credentials:LCSW, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 CANTIGNEY ST
Mailing Address - Street 2:
Mailing Address - City:CORNING
Mailing Address - State:NY
Mailing Address - Zip Code:14830-2018
Mailing Address - Country:US
Mailing Address - Phone:607-654-2901
Mailing Address - Fax:
Practice Address - Street 1:201 CANTIGNEY ST
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:NY
Practice Address - Zip Code:14830-2018
Practice Address - Country:US
Practice Address - Phone:607-654-2901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY092060101YP2500X
NY26391101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)