Healthcare Provider Details

I. General information

NPI: 1316842446
Provider Name (Legal Business Name): NATASHA PAYNE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

953 AUBURN ST
HANNIBAL NY
13074-2180
US

IV. Provider business mailing address

61 DELANO ST
PULASKI NY
13142-1400
US

V. Phone/Fax

Practice location:
  • Phone: 315-602-4030
  • Fax: 315-282-2300
Mailing address:
  • Phone: 315-298-6564
  • Fax: 315-298-3968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number133982
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: