Individual
MR. JERALD PAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSCSW, LCSW
Contact information
Practice address
3914 WASHINGTON ST, KANSAS CITY, MO 64111-2925
(816) 864-4201
(816) 561-8199
Mailing address
3914 WASHINGTON ST, KANSAS CITY, MO 64111-2925
(816) 864-4201
(816) 561-8199
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2001031825
MO
1041C0700X
Clinical Social Worker
2169
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200256670-A
—
KS
05
—
495380404
—
MO
05
—
495380420
—
MO
Enumeration date
01/30/2007
Last updated
04/10/2015
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