Provider Demographics
NPI:1174598783
Name:PAYNE, SHARON L (CSW)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:L
Last Name:PAYNE
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 NEWTOWN RD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-5600
Mailing Address - Country:US
Mailing Address - Phone:757-490-0725
Mailing Address - Fax:757-496-6504
Practice Address - Street 1:533 NEWTOWN RD
Practice Address - Street 2:SUITE 115
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-5600
Practice Address - Country:US
Practice Address - Phone:757-490-0725
Practice Address - Fax:757-496-6504
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-18
Last Update Date:2007-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904000297001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical