Individual provider Active NPI

Imani Renee Payton, LPCC

  • Mental Health Counselor
  • Roseburg, OR
National Provider Identifier
1871474320
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPCC.0023579 Issued in CO
Practice address
272 NW Medical Loop Ste E
Roseburg, OR 97471-5545
Phone
(541) 900-4285
Fax
(888) 810-2993
NPI assigned
Sep 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPCC.0023579 CO Primary

Addresses

Primary practice location

272 NW Medical Loop Ste E
Roseburg, OR 97471-5545

Mailing address

272 NW Medical Loop Ste E
Roseburg, OR 97471-5545
Phone (541) 900-4285

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
LPCC.0023579COMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1757462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1871474320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "272 NW MEDICAL LOOP STE E",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974715545",
            "telephone_number": "541-900-4285",
            "fax_number": "888-810-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "272 NW MEDICAL LOOP STE E",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974715545",
            "telephone_number": "541-900-4285",
            "fax_number": "888-810-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYTON",
        "first_name": "IMANI",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-10",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPCC.0023579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2025; 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.