Provider Demographics
NPI:1619612090
Name:PAYTON, AMACHIYANA (MSW, LICSW)
Entity type:Individual
Prefix:MS
First Name:AMACHIYANA
Middle Name:
Last Name:PAYTON
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 PENNSYLVANIA AVE SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-2408
Mailing Address - Country:US
Mailing Address - Phone:202-878-6626
Mailing Address - Fax:
Practice Address - Street 1:3300 PENNSYLVANIA AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-2408
Practice Address - Country:US
Practice Address - Phone:202-878-6626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-01
Last Update Date:2025-02-27
Deactivation Date:2022-08-27
Deactivation Code:
Reactivation Date:2025-02-25
Provider Licenses
StateLicense IDTaxonomies
DCLC500805701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty