Provider Demographics
NPI:1285209981
Name:PAYNE, ANNE
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:PAYNE
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 1:1964 ASHLEY RIVER RD UNIT 80901B
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29416-1637
Mailing Address - Country:US
Mailing Address - Phone:843-229-3814
Mailing Address - Fax:888-808-4249
Practice Address - Street 1:1964B ASHLEY RIVER RD. #80901
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29416
Practice Address - Country:US
Practice Address - Phone:843-229-3814
Practice Address - Fax:888-808-4249
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst