Mariya Javed-Payne, LICSW, LADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

22773 Issued in MN

Practice address

9300 Hennepin Town Rd Ste 110
Eden Prairie, MN 55347-3072

Phone

(763) 232-4694

NPI assigned

Dec 24, 2018

Last updated

Jan 17, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: mjaved407059@excellian.direct.allina.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1545609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1063984474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 W 84TH ST APT 2",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554371367",
            "telephone_number": "763-232-4694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 HENNEPIN TOWN RD STE 110",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553473072",
            "telephone_number": "763-232-4694"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1026 7th St W",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551023828",
            "country_code": "US",
            "telephone_number": "651-241-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAVED-PAYNE",
        "first_name": "MARIYA",
        "credential": "LICSW, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-24",
        "last_updated": "2023-01-17",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "22773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.