Provider Demographics
NPI:1043240138
Name:PAYNE, CATHERINE M (PHD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:M
Last Name:PAYNE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6832 OLD DOMINION DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3887
Mailing Address - Country:US
Mailing Address - Phone:703-790-7279
Mailing Address - Fax:703-734-0910
Practice Address - Street 1:6832 OLD DOMINION DR
Practice Address - Street 2:SUITE 200
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3887
Practice Address - Country:US
Practice Address - Phone:703-790-7279
Practice Address - Fax:703-734-0910
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001450103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7745044Medicaid
VA7745044Medicaid