Provider Demographics
NPI:1114170891
Name:PAYNE, BETH LOUISE (MSW)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:LOUISE
Last Name:PAYNE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5041 NEW CENTRE DRIVE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403
Mailing Address - Country:US
Mailing Address - Phone:910-392-8990
Mailing Address - Fax:910-392-8991
Practice Address - Street 1:5041 NEW CENTRE DR
Practice Address - Street 2:SUITE 209
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-1680
Practice Address - Country:US
Practice Address - Phone:910-392-8990
Practice Address - Fax:910-392-8991
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health