Provider Demographics
NPI:1922293539
Name:PAYNE, JOANN WILBERS (LISW)
Entity Type:Individual
Prefix:MRS
First Name:JOANN
Middle Name:WILBERS
Last Name:PAYNE
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6148 WOODLARK DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-2718
Mailing Address - Country:US
Mailing Address - Phone:513-232-5289
Mailing Address - Fax:
Practice Address - Street 1:2020 SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:OH
Practice Address - Zip Code:45212-2616
Practice Address - Country:US
Practice Address - Phone:513-924-2800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 05000291041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool