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General NPI Number Information
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NPI Number | 1427642404
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Entity Type | Individual
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Provider Name | NANCY PAYNE LICSW, PIP
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Gender | Female
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Dates
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Enumeration Date | 02/21/2021
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Last Update Date | 05/29/2024
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Provider Practice Location Address
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Address Line | 420 28TH AVE STE 200
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City | TUSCALOOSA
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State | AL
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Zip | 35401-1089
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Country | US
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Telephone | 205-737-3720
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Fax | 205-310-9969
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Provider Business Mailing Address
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Address Line | 3706 SHOREVIEW DR
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City | TUSCALOOSA
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State | AL
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Zip | 35405-4608
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Country | US
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Telephone | 205-792-2979
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0651C
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License Number State | AL
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