Provider Demographics
NPI:1841566981
Name:ARKADIE AND PAYNE, LCSW
Entity type:Organization
Organization Name:ARKADIE AND PAYNE, LCSW
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LENA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:909-962-7323
Mailing Address - Street 1:PO BOX 464
Mailing Address - Street 2:
Mailing Address - City:ETIWANDA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-0464
Mailing Address - Country:US
Mailing Address - Phone:909-962-7323
Mailing Address - Fax:909-962-7323
Practice Address - Street 1:9587 ARROW RTE
Practice Address - Street 2:SUITE K
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-4551
Practice Address - Country:US
Practice Address - Phone:909-962-7323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-22
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty