Provider Demographics
NPI:1922712769
Name:PAYNE, DEANN LYNN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DEANN
Middle Name:LYNN
Last Name:PAYNE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:DEANN
Other - Middle Name:T
Other - Last Name:CRADDOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:279 N GROVE MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29303-4222
Mailing Address - Country:US
Mailing Address - Phone:864-582-7025
Mailing Address - Fax:
Practice Address - Street 1:279 N GROVE MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-4222
Practice Address - Country:US
Practice Address - Phone:864-582-7025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5124103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist