Paytons Place, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20042225A Issued in IN

Legal business name

PAYTONS PLACE, LLC

Practice address

409 East Cook Rd
Suite 100
Fort Wayne, IN 46825

Phone

(260) 498-9933

NPI assigned

Dec 13, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Marla Souder, PSY.D., HSPP

Title

Owner/President/Psychologist

Phone

(260) 498-9933

Specialties & licenses 8

Addresses

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

{
    "created_epoch": "1386892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386892800000",
    "number": "1104247337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2599 COUNTY ROAD 72",
            "city": "AUBURN",
            "state": "IN",
            "postal_code": "46706",
            "telephone_number": "260-498-9933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 EAST COOK RD",
            "address_2": "SUITE 100",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46825",
            "telephone_number": "260-498-9933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAYTONS PLACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-13",
        "last_updated": "2013-12-13",
        "status": "A",
        "authorized_official_last_name": "SOUDER",
        "authorized_official_first_name": "MARLA",
        "authorized_official_title_or_position": "OWNER/PRESIDENT/PSYCHOLOGIST",
        "authorized_official_telephone_number": "260-498-9933",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D., HSPP"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042225A",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roy E Payne, LMFT
• Erica Ann Payson, BA
• Angela M. Payton, NP
• Antia Marie Payton
• Bernadine Payton, MS.ED, BSW
• Jeffrey Giron Payumo, M.D.
• Peace of Mind in Home Care, LLC
• Peaceful Waves Counseling LLC
• Tina Peaks
• Melissa Pearman, LMFT

• Clinical Psychologist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; 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.