Provider Demographics
NPI:1932640620
Name:PAYNE, ERIN K (LIMFT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:K
Last Name:PAYNE
Suffix:
Gender:F
Credentials:LIMFT
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:K
Other - Last Name:MOULTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:434 EASTLAND RD
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:OH
Mailing Address - Zip Code:44017-1217
Mailing Address - Country:US
Mailing Address - Phone:440-260-8327
Mailing Address - Fax:
Practice Address - Street 1:3500 CARNEGIE AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115
Practice Address - Country:US
Practice Address - Phone:440-260-8300
Practice Address - Fax:440-260-8575
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-14
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF.1500027106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist