Healthcare Provider Details

I. General information

NPI: 1164741815
Provider Name (Legal Business Name): LEAH R PAYNE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LEAH R LUFT LCSW

II. Dates (important events)

Enumeration Date: 05/20/2010
Last Update Date: 04/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 W GREENE STREET
WEBSTER TX
77598
US

IV. Provider business mailing address

409 W GREENE STREET
WEBSTER TX
77598
US

V. Phone/Fax

Practice location:
  • Phone: 281-332-4738
  • Fax: 281-724-6058
Mailing address:
  • Phone: 281-332-4738
  • Fax: 281-724-6058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW9831
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: