Provider Demographics
NPI:1033483326
Name:PAYNE, CHRISTIE (RD, LPC)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTIE
Middle Name:
Last Name:PAYNE
Suffix:
Gender:F
Credentials:RD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16227 N 153RD AVE
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-7413
Mailing Address - Country:US
Mailing Address - Phone:770-744-3748
Mailing Address - Fax:
Practice Address - Street 1:10451 W PALMERAS DR
Practice Address - Street 2:SUITE 221 E
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85373-2011
Practice Address - Country:US
Practice Address - Phone:770-744-3748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-03
Last Update Date:2012-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-13207101YM0800X
AZRD 864804133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health