NPIMap

Individual provider Active NPI

Richard Payne, LPCC

  • Professional Counselor
  • Fairfield, OH
National Provider Identifier
1336686120
Registry record updated May 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.1901425 Issued in OH
Practice address
1251 Nilles Rd Ste 5
Fairfield, OH 45014-7205
Phone
(513) 939-0300
Fax
(513) 939-0310
NPI assigned
Jan 31, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA.162568 OH
Mental Health Counselor 101YM0800X C.1500925 OH
Professional Counselor 101YP2500X E.1901425 OH Primary

Addresses

Primary practice location

1251 Nilles Rd Ste 5
Fairfield, OH 45014-7205

Mailing address

1251 Nilles Rd Ste 5
Fairfield, OH 45014-7205
Phone (513) 939-0300

Other practice location 1

4464 S Dixie Hwy
Middletown, OH 45005-5464
Phone (513) 649-8008 ext. 22

Other identifiers 3

IdentifierTypeStateIssuer
01-0693OtherOHCARF CERTIFICATION
0074861OtherOHMEDICAID ODADAS
0074946OtherOHMEDICAID ODMH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CDCA.162568OHMDAddiction (Substance Use Disorder) Counselor
C.1500925OHMDMental Health Counselor
E.1901425OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Access Counseling Services LLC Addiction (Substance Use Disorder) PastSince Nov 4, 2014 Accepting new patients
Access Counseling Services, LLC Addiction (Substance Use Disorder) Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1485820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589328000000",
    "number": "1336686120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 NILLES RD STE 5",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450147205",
            "telephone_number": "513-939-0300",
            "fax_number": "513-939-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 NILLES RD STE 5",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450147205",
            "telephone_number": "513-939-0300",
            "fax_number": "513-939-0310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4464 S Dixie Hwy",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "OH",
            "postal_code": "450055464",
            "country_code": "US",
            "telephone_number": "513-649-8008 x22",
            "fax_number": "513-649-8004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "RICHARD",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-31",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.162568",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.1500925",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.1901425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARF CERTIFICATION",
            "identifier": "01-0693",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID ODADAS",
            "identifier": "0074861",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID ODMH",
            "identifier": "0074946",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; 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.