Provider Demographics
NPI:1457621591
Name:PAYNE, ADAM C (LMSW)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:C
Last Name:PAYNE
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 PARK TERRACE EAST
Mailing Address - Street 2:#2E
Mailing Address - City:NYC
Mailing Address - State:NY
Mailing Address - Zip Code:10034-1074
Mailing Address - Country:US
Mailing Address - Phone:646-559-4052
Mailing Address - Fax:
Practice Address - Street 1:70 PARK TER E
Practice Address - Street 2:#2E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-1409
Practice Address - Country:US
Practice Address - Phone:646-559-4052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY083441101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY083441OtherNYSED