Healthcare Provider Details

I. General information

NPI: 1356245195
Provider Name (Legal Business Name): CAROLINE PAYNE MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

659 AUBURN AVE NE APT 103
ATLANTA GA
30312-1954
US

IV. Provider business mailing address

2216 MAIN ST NW
ATLANTA GA
30318-1127
US

V. Phone/Fax

Practice location:
  • Phone: 478-697-6670
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: