MEDICARE: CORINTHIA DOMINIQUE PAYLOR

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
1	106S00000X	Behavior Technician	RBT-21-165041	DC
2	104100000X	Social Worker	LG200003200	DC

General Provider Information

NPI Number	:	1407426489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORINTHIA DOMINIQUE PAYLOR

Provider Business Mailing Address
First Line	:	538 PUGSLEY AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10473-1807
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4400 MACARTHUR BLVD NW STE 300
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20007-2521
Country	:	US
Telephone Number	:	202-747-6665
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2021
Last Update Date	:	10/08/2025

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Directions to “ CORINTHIA DOMINIQUE PAYLOR ” Practice Location

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