Provider Demographics
NPI:1548067820
Name:LE, PAYTON CHRISTINE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:PAYTON
Middle Name:CHRISTINE
Last Name:LE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6776 LAKE DR STE 170
Mailing Address - Street 2:
Mailing Address - City:LINO LAKES
Mailing Address - State:MN
Mailing Address - Zip Code:55014-1201
Mailing Address - Country:US
Mailing Address - Phone:763-291-5505
Mailing Address - Fax:
Practice Address - Street 1:6776 LAKE DR STE 170
Practice Address - Street 2:
Practice Address - City:LINO LAKES
Practice Address - State:MN
Practice Address - Zip Code:55014-1201
Practice Address - Country:US
Practice Address - Phone:763-291-5505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4643106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist