Provider Demographics
NPI:1477807030
Name:PAYNE, ERIN CRANDALL (MS, LPC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:CRANDALL
Last Name:PAYNE
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:CRANDALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPC
Mailing Address - Street 1:204 SANTA FE TRL
Mailing Address - Street 2:APT 3006
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-4719
Mailing Address - Country:US
Mailing Address - Phone:817-797-4084
Mailing Address - Fax:
Practice Address - Street 1:4325 WINDSOR CENTRE TRL
Practice Address - Street 2:STE 200
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1863
Practice Address - Country:US
Practice Address - Phone:972-338-5807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-05
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69485101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional