Provider Demographics
NPI:1518078237
Name:PAYNE-BUTLER, CANDACE CHARLENE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CANDACE
Middle Name:CHARLENE
Last Name:PAYNE-BUTLER
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 1:5820 E WT HARRIS BLVD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-3541
Mailing Address - Country:US
Mailing Address - Phone:704-277-7031
Mailing Address - Fax:
Practice Address - Street 1:5820 E WT HARRIS BLVD
Practice Address - Street 2:SUITE 211
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-3541
Practice Address - Country:US
Practice Address - Phone:704-277-7031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0054261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical