Healthcare Provider Details

I. General information

NPI: 1033483326
Provider Name (Legal Business Name): CHRISTIE PAYNE RD, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2012
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3305 BRECKINRIDGE BLVD STE 116
DULUTH GA
30096-4932
US

IV. Provider business mailing address

3305 BRECKINRIDGE BLVD STE 116
DULUTH GA
30096-4932
US

V. Phone/Fax

Practice location:
  • Phone: 578-829-2573
  • Fax:
Mailing address:
  • Phone: 623-293-8266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC002324
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number864804
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: