Provider Demographics
NPI:1295882199
Name:MERRILL PAYNE, ROBIN KAY (LCSW)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:KAY
Last Name:MERRILL PAYNE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 MONTECITO BLVD
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-2115
Mailing Address - Country:US
Mailing Address - Phone:707-257-7411
Mailing Address - Fax:
Practice Address - Street 1:2261 ELM ST
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-3721
Practice Address - Country:US
Practice Address - Phone:707-253-4710
Practice Address - Fax:707-253-4815
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS160921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical