Provider Demographics
NPI:1881475564
Name:PAYNE, DARRIN D (MA, APC, BS MIN)
Entity type:Individual
Prefix:
First Name:DARRIN
Middle Name:D
Last Name:PAYNE
Suffix:
Gender:M
Credentials:MA, APC, BS MIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1135 GARIBALDI ST SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30310-3661
Mailing Address - Country:US
Mailing Address - Phone:470-800-2784
Mailing Address - Fax:
Practice Address - Street 1:1000 JOHNSON FERRY RD STE E150
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-2176
Practice Address - Country:US
Practice Address - Phone:770-656-4676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC008405101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health