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NPI Code Detail

MEDICARE: KALYNN LARISA PAYNE

MEDICARE: KALYNN LARISA PAYNE
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
1106H00000XMarriage & Family Therapist
2101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1578211579
Entity Type Code : Individual
Provider Name (Legal Business Name) : KALYNN LARISA PAYNE
Provider Business Mailing Address
First Line : 115 CIRCLE DR
Second Line :
City : MARKLEEVILLE
State : CA
Zip : 96120-9300
Country : US
Telephone Number : 530-721-7778
Fax Number :
Provider Business Practice Location Address
First Line : 2802 BROADWAY
Second Line :
City : EVERETT
State : WA
Zip : 98201-3642
Country : US
Telephone Number : 425-259-3191
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2022
Last Update Date : 04/14/2026

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Directions to “ KALYNN LARISA PAYNE ” Practice Location

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