Active NPI
Timothy M. Payne, LCSW, MSW
- Clinical Social Worker
- Missoula, MT
National Provider Identifier
1649368671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 623
- Practice address
- 3031 S Russell St
Missoula, MT 59801-8523 - Phone
- (406) 728-9814
- NPI assigned
- Oct 11, 2006
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 623 | MT | Primary |
Addresses
Primary practice location
3031 S Russell St
Missoula, MT 59801-8523
Mailing address
3031 S Russell St
Missoula, MT 59801-8523
Phone (406) 728-9814
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 623 | MT | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462406400000",
"number": "1649368671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3031 S RUSSELL ST",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598018523",
"telephone_number": "406-728-9814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3031 S RUSSELL ST",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598018523",
"telephone_number": "406-728-9814"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAYNE",
"first_name": "TIMOTHY",
"middle_name": "M.",
"name_prefix": "Mr.",
"credential": "LCSW, MSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-11",
"last_updated": "2016-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MT",
"license": "623",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Missoula, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.