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General NPI Number Information
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NPI Number | 1023872298
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Entity Type | Individual
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Provider Name | CHANTAE PAYNE
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Gender | Female
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Dates
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Enumeration Date | 02/08/2024
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Last Update Date | 02/23/2025
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Provider Practice Location Address
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Address Line | 31500 CHIEFTAIN DR
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City | LOGAN
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State | OH
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Zip | 43138-8421
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Country | US
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Telephone | 740-270-3286
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Fax |
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Provider Business Mailing Address
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Address Line | 9 CHESAPEAKE PLZ
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City | CHESAPEAKE
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State | OH
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Zip | 45619-1003
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Country | US
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Telephone | 931-367-6850
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | C.2405510-TRNE
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License Number State | OH
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