Provider Demographics
NPI:1225374697
Name:PAYNE, DAWN JONES (MSW LCSWA)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:JONES
Last Name:PAYNE
Suffix:
Gender:F
Credentials:MSW LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1645 CHERRY BLOSSOM LN UNIT 103
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27127-3222
Mailing Address - Country:US
Mailing Address - Phone:336-501-3057
Mailing Address - Fax:
Practice Address - Street 1:1645 CHERRY BLOSSOM LN UNIT 103
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27127-3222
Practice Address - Country:US
Practice Address - Phone:336-501-3057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-12
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP00064901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical