Provider Demographics
NPI:1538377601
Name:PAYNE, CARRIE S (LMHC)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:S
Last Name:PAYNE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 124TH ST SW
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-5696
Mailing Address - Country:US
Mailing Address - Phone:206-459-7031
Mailing Address - Fax:425-347-2677
Practice Address - Street 1:3602 COLBY AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4714
Practice Address - Country:US
Practice Address - Phone:206-459-7031
Practice Address - Fax:425-347-2677
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-20
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA6896101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health