Provider Demographics
NPI:1891891545
Name:PAYNE, MICHELE (LMFT)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:PAYNE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 624
Mailing Address - Street 2:
Mailing Address - City:MERRYVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70653-0624
Mailing Address - Country:US
Mailing Address - Phone:337-353-2640
Mailing Address - Fax:
Practice Address - Street 1:271 PULLEM BRANCH RD
Practice Address - Street 2:
Practice Address - City:MERRYVILLE
Practice Address - State:LA
Practice Address - Zip Code:70653
Practice Address - Country:US
Practice Address - Phone:337-353-2640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1096101YA0400X
LA806106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)