Healthcare Provider Details

I. General information

NPI: 1326087255
Provider Name (Legal Business Name): DEBORAH F PAYTON LMSW LLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 02/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 WEST SOUTH BOULEVARD 200
ROCHESTER HILLS MI
48307-5160
US

IV. Provider business mailing address

28000 DEQUINDRE RD
WARREN MI
48092-2468
US

V. Phone/Fax

Practice location:
  • Phone: 248-844-6234
  • Fax: 248-844-6237
Mailing address:
  • Phone: 586-753-1083
  • Fax: 586-753-1088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6301002418
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801011593
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: