Healthcare Provider Details

I. General information

NPI: 1952235319
Provider Name (Legal Business Name): GRACE PAYNE LCMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

315 S SALEM ST STE 222
APEX NC
27502-1848
US

IV. Provider business mailing address

315 S SALEM ST STE 222
APEX NC
27502-1848
US

V. Phone/Fax

Practice location:
  • Phone: 919-909-7959
  • Fax: 919-246-9390
Mailing address:
  • Phone: 919-909-7959
  • Fax: 919-246-9390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberA21850
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: