Kellie A Payne, LPCC LLCDC LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

E0002484 Issued in OH

Practice address

2770 Centennial Rd
Toledo, OH 43617-1829

Phone

(419) 794-0567

Fax

(419) 794-0569

NPI assigned

Nov 30, 2006

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

Other identifiers 3

Other names 1

• Kellie A Payne-Schramm Former name

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Comprehensive Behavioral Health Services LLCGroup PAC ID 2264502541, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Comprehensive Behavioral Health Services LLC

  • Child & Adolescent Psychiatry Physician
  • Toledo, OH
  • NPI 1821266438
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465257600000",
    "number": "1144397340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2770 CENTENNIAL RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436171829",
            "telephone_number": "419-794-0567",
            "fax_number": "419-794-0569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2770 CENTENNIAL RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436171829",
            "telephone_number": "419-794-0567",
            "fax_number": "419-794-0569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "KELLIE",
        "middle_name": "A",
        "credential": "LPCC LLCDC LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2016-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "975872",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "E0002484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF OH CHEMICAL DEPE",
            "identifier": "975872",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SATE OF OHIO COUNSELOR",
            "identifier": "E0002484",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL WORKER",
            "identifier": "S0020474",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLIE",
            "last_name": "PAYNE-SCHRAMM",
            "middle_name": "A",
            "credential": "LPCC LLCDC LSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Aaron Payne
• Andria Payne, LPN
• Cierra Payne
• Cletus Payne, CNP
• Kathleen Payne
• Lindsey Payne
• Nicole Marie Payne, MD
• Deanna Payton, LPN
• Alexander Payvandi, DO
• PC Stiff MD Inc

• Social Worker in Toledo, OH
• Providers in Toledo, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.