Healthcare Provider Details

I. General information

NPI: 1154254423
Provider Name (Legal Business Name): LEIA PAYNE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8735 DUNWOODY PL # 13210
SANDY SPRINGS GA
30350-2995
US

IV. Provider business mailing address

8735 DUNWOODY PL # 13210
SANDY SPRINGS GA
30350-2995
US

V. Phone/Fax

Practice location:
  • Phone: 762-499-4213
  • Fax:
Mailing address:
  • Phone: 762-499-4213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC016918
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: