Provider Demographics
NPI:1437570165
Name:PAYTON, ARTREVISA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ARTREVISA
Middle Name:
Last Name:PAYTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21750 HARDY OAK BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4946
Mailing Address - Country:US
Mailing Address - Phone:601-890-2678
Mailing Address - Fax:210-960-9539
Practice Address - Street 1:1409 ARGYLL PARK
Practice Address - Street 2:
Practice Address - City:BULVERDE
Practice Address - State:TX
Practice Address - Zip Code:78163-3517
Practice Address - Country:US
Practice Address - Phone:601-890-2678
Practice Address - Fax:210-960-9539
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-23
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX577151041S0200X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool