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General NPI Number Information
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NPI Number | 1922407923
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Entity Type | Individual
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Provider Name | JESSICA L PAYNE PSYD, MSW
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Gender | Female
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Dates
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Enumeration Date | 08/15/2014
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Last Update Date | 12/07/2023
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Provider Practice Location Address
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Address Line | 1441 KAPIOLANI BLVD STE 1600
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City | HONOLULU
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State | HI
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Zip | 96814-4407
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Country | US
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Telephone | 808-432-7600
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Fax |
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Provider Business Mailing Address
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Address Line | 1441 KAPIOLANI BLVD STE 1802
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City | HONOLULU
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State | HI
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Zip | 96814-4408
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Country | US
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Telephone |
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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 | C-03134
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801095273
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2124
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License Number State | HI
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