Individual provider Active NPI

E. Christopher Payne, PH.D.

  • Counseling Psychologist
  • Breinigsville, PA
National Provider Identifier
1578556403
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
PS006290L Issued in PA
Practice address
628 Twin Ponds Rd
Breinigsville, PA 18031-1843
Phone
(610) 434-7820
Fax
(610) 434-8210
NPI assigned
Aug 25, 2005
Last updated
Sep 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X PS006290L PA Primary

Addresses

Primary practice location

628 Twin Ponds Rd
Breinigsville, PA 18031-1843

Mailing address

628 Twin Ponds Rd
Breinigsville, PA 18031-1843
Phone (610) 434-7820

Other identifiers 1

IdentifierTypeStateIssuer
739347OtherPAHIGHMARK BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20101004000840 PA Practitioner - Clinical Psychologist 3173715562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

628 Twin Ponds Rd
Breinigsville, PA 18031-1843
Phone (610) 434-7820

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Advocates for Behavioral Change Counseling CurrentSince Jun 13, 1998 Accepting new patients

Locations

1544 Hamilton St
Fl 1
Allentown, PA 18102
Phone (610) 434-7820

628 Twin Ponds Rd
Breinigsville, PA 18031
Phone (484) 263-0197

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1578556403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 TWIN PONDS RD",
            "city": "BREINIGSVILLE",
            "state": "PA",
            "postal_code": "180311843",
            "telephone_number": "610-434-7820",
            "fax_number": "610-434-8210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 TWIN PONDS RD",
            "city": "BREINIGSVILLE",
            "state": "PA",
            "postal_code": "180311843",
            "telephone_number": "610-434-7820",
            "fax_number": "610-434-8210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "E. CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "PA",
            "license": "PS006290L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "739347",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Breinigsville, PA

Sources for this page

Verify at the official NPI Registry.