Active NPI
Demah Payne III, LPCA
- Professional Counselor
- Raleigh, NC
National Provider Identifier
1477974590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- A10590
- Practice address
- 1708 Trawick Rd
Raleigh, NC 27604-3897 - Phone
- (919) 896-7536
- NPI assigned
- Dec 16, 2013
- Last updated
- Dec 16, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | A10590 | NC | Primary |
Addresses
Primary practice location
1708 Trawick Rd
Raleigh, NC 27604-3897
Mailing address
5221 Malik Dr
Durham, NC 27703-9375
Phone (919) 302-7695
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
| License | State | Type | Specialty |
|---|---|---|---|
| A10590 | NC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1387152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1387152000000",
"number": "1477974590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5221 MALIK DR",
"city": "DURHAM",
"state": "NC",
"postal_code": "277039375",
"telephone_number": "919-302-7695"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1708 TRAWICK RD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276043897",
"telephone_number": "919-896-7536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAYNE",
"first_name": "DEMAH",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "LPCA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-12-16",
"last_updated": "2013-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "A10590",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.