Jayne Payne, LCDC, ADCIII, PHD.

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Waelder, TX

NPI 1669977708 · NPPES record last updated Mar 29, 2018

Key facts

NPI
1669977708
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
1724 (TX)
Practice address
4168 County Road 444
Waelder, TX 78959-5328
Phone
(832) 797-2486
NPI assigned
Mar 29, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1724TXMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1724 TX Yes

Addresses

Primary practice location

4168 County Road 444
Waelder, TX 78959-5328

Mailing address

PO Box 86
Waelder, TX 78959-0086
Phone (832) 797-2426

Other providers in Waelder, TX

All providers in Waelder, TX · Addiction (Substance Use Disorder) Counselor in Texas

Sources for this page

Verify at the official NPI Registry.