Provider Demographics
NPI:1962076752
Name:PAYNE, TECIA RENEE
Entity type:Individual
Prefix:
First Name:TECIA
Middle Name:RENEE
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 1:847 W KEMPER RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-2521
Mailing Address - Country:US
Mailing Address - Phone:513-503-8487
Mailing Address - Fax:
Practice Address - Street 1:4531 READING RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-1229
Practice Address - Country:US
Practice Address - Phone:513-751-8600
Practice Address - Fax:513-381-5959
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor