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NPI Code Detail

MEDICARE: SYDNEY PAYNE

MEDICARE: SYDNEY PAYNE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker6851118966MI

General Provider Information

NPI Number : 1376361113
Entity Type Code : Individual
Provider Name (Legal Business Name) : SYDNEY PAYNE
Provider Business Mailing Address
First Line : 1485 M 139
Second Line :
City : BENTON HARBOR
State : MI
Zip : 49022-5711
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1485 M 139
Second Line :
City : BENTON HARBOR
State : MI
Zip : 49022-5711
Country : US
Telephone Number : 269-925-0585
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2024
Last Update Date : 03/17/2026

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Directions to “ SYDNEY PAYNE ” Practice Location

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