Provider Demographics
NPI:1063220515
Name:PAYNE CALLENDER, RENEE
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:PAYNE CALLENDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 ASHMONT ST
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02124-3810
Mailing Address - Country:US
Mailing Address - Phone:617-594-3905
Mailing Address - Fax:
Practice Address - Street 1:300 ASHMONT ST
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02124-3810
Practice Address - Country:US
Practice Address - Phone:617-594-3905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional