Provider Demographics
NPI:1245989979
Name:PAYNE, CHRISTOPHER WELBORN (LCSW)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:WELBORN
Last Name:PAYNE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3950 SPRING VALLEY RD APT 335
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75244-3472
Mailing Address - Country:US
Mailing Address - Phone:214-403-2945
Mailing Address - Fax:
Practice Address - Street 1:3950 SPRING VALLEY RD APT 335
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75244-3472
Practice Address - Country:US
Practice Address - Phone:214-403-2945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX655161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical