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NPI Code Detail

MEDICARE: MRS. CHRISTIE PAYNE RD, LPC

MEDICARE: MRS. CHRISTIE PAYNE RD, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorLPC002324GA
2133V00000XRegistered Dietitian864804GA

General Provider Information

NPI Number : 1033483326
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHRISTIE PAYNE RD, LPC
Provider Business Mailing Address
First Line : 3305 BRECKINRIDGE BLVD STE 116
Second Line :
City : DULUTH
State : GA
Zip : 30096-4932
Country : US
Telephone Number : 623-293-8266
Fax Number :
Provider Business Practice Location Address
First Line : 3305 BRECKINRIDGE BLVD STE 116
Second Line :
City : DULUTH
State : GA
Zip : 30096-4932
Country : US
Telephone Number : 578-829-2573
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2012
Last Update Date : 06/10/2026

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