Jessica Lynn Payne, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401223466 Issued in MI

Practice address

383 Starkweather St Ste 1
Plymouth, MI 48170-1373

Phone

(734) 386-0238

NPI assigned

Feb 10, 2020

Last updated

Feb 15, 2024By 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 3

Addresses

Other names 1

• Jessica Lynn Pepple Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 2, 2024 through Jan 2, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Indigo North, LLC

  • Professional Counselor
  • Plymouth, MI
  • NPI 1487233516
  NPD Authorized official
• Reset Brain Plus Body LLC

  • Mental Health Counselor
  • Plymouth, MI
  • NPI 1356803399
  NPD (past)

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1215569991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42524 SARATOGA RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481873011",
            "telephone_number": "734-386-0238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "383 STARKWEATHER ST STE 1",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701373",
            "telephone_number": "734-386-0238"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "42524 Saratoga Rd",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "MI",
            "postal_code": "481873011",
            "country_code": "US",
            "telephone_number": "734-386-0238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-10",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401223466",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401223466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "PEPPLE",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Paul Kenzie OD PC
• Paul Kenzie, O.D., P.C.
• Angela Paul
• Valentina Pauls
• Linnea Paulsen
• Sarah Payne
• Peaceful Banyan
• Charmaine Peake
• Christian Pearson
• Audrey Lynn Peck

• Professional Counselor in Plymouth, MI
• Providers in Plymouth, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.