PAYTONS PLACE, LLC (NPI# 1104247337) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104247337 |
| Entity Type | Organization |
| Organization Name | PAYTONS PLACE, LLC |
| Practice Address |
409 East Cook Rd Suite 100 Fort Wayne IN 46825 |
| Mailing Address |
2599 County Road 72 Auburn IN 46706 |
| Practice Telephone | 2604989933 |
| Mailing Telephone | 2604989933 |
| Enumeration Date | 2013-12-13 |
| Last Update Date | 2013-12-13 |
| Authorized Official Name | DR. MARLA SOUDER (OWNER/PRESIDENT/PSYCHOLOGIST) |
| Authorized Official Telephone | 2604989933 |
| Authorized Official Credential | PSY.D., HSPP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 222Q00000X | Developmental Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers | ||
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care | ||
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
20042225A | IN | Behavioral Health & Social Service Providers |
| Street Address |
409 EAST COOK RD SUITE 100 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46825 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336772078 | Bradley Murphy | Occupational Therapist | 2626 St Joe Center Ed, Fort Wayne, IN 46825 | 2020-02-21 |
| 1144851015 | Sabryna Roman | Developmental Therapist | 2626 St Joe Center Rd, Fort Wayne, IN 46825 | 2020-01-30 |
| 1205474103 | Ashleigh Miller | Developmental Therapist | 2626 St. Joe Center Rd, Fort Wayne, IN 46825 | 2019-12-11 |
| 1962055152 | Carehalo Ohio LLC | General Practice | 2510 Dupont Circle Dr., Suite 201, Fort Wayne, IN 46825 | 2019-07-17 |
| 1306318175 | Logan Alan Williams | Nurse Anesthetist, Certified Registered | 10315 Dawsons Creek Blvd Ste B, Fort Wayne, IN 46825 | 2018-12-18 |
| 1326582925 | Mark F Stoner LLC | Dentist | 9830 Auburn Rd Suite 102, Fort Wayne, IN 46825 | 2016-12-15 |
| 1336695782 | Nadine Rene' Handy | Nurse Practitioner | 3978 New Vision Dr., Fort Wayne, IN 46825 | 2016-08-26 |
| 1558815712 | Nathan Paul Miller | Physical Therapist | 10006 Auburn Park Dr, Fort Wayne, IN 46825 | 2016-08-05 |
| 1013366905 | Brianna Abbott | Physician Assistant | 1234 E Dupont Rd Ste 7, Fort Wayne, IN 46825 | 2016-06-10 |
| 1003276643 | Seiss, LLC | Psychologist | 9910 Dupont Circle Drive, Suite 140, Fort Wayne, IN 46825 | 2016-02-24 |
| Find all providers in zip 46825 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164052791 | Kadlec Consulting Services, LLC | Psychologist | 5525 Oak Valley Pl, Fort Wayne, IN 46845-1836 | 2020-01-23 |
| 1053628248 | Kelly Stewart Hutner | Psychologist | 11143 Parkview Plaza Dr Ste 320, Fort Wayne, IN 46845-1728 | 2010-09-09 |
| 1730495813 | Spencer Jenkins Booth | Psychologist | 6526 W Jefferson Blvd, Fort Wayne, IN 46804-6206 | 2010-08-26 |
| 1750519377 | Thomas Paul Dettmer | Psychologist | 6223 Constitution Dr, Fort Wayne, IN 46804-1517 | 2009-06-23 |
| 1750509667 | Casey Nelson | Psychologist | 1515 Magnavox Way, Fort Wayne, IN 46804-1533 | 2007-04-23 |
| 1982732491 | Shirley F Shiff | Psychologist | 8424 Victoria Woods Pl, Fort Wayne, IN 46825-6510 | 2007-02-28 |
| 1912080359 | Abigail Dormire Powers | Psychologist | 10311 Dawsons Creek Blvd, Suite F, Fort Wayne, IN 46825-1913 | 2006-10-21 |
| 1376593046 | Wayne James Von Bargen | Psychologist | 1910 Saint Joe Center Rd, Suite 44, Fort Wayne, IN 46825-5000 | 2006-05-11 |
| 1093774796 | Mcgee-lytle Inc | Psychologist | 2020 E Washington Blvd, Suite 650, Fort Wayne, IN 46803-1327 | 2006-03-21 |
| 1043283641 | Jason T. Cook | Psychologist | 7230 Engle Rd, Ste 304, Fort Wayne, IN 46804-2209 | 2006-02-13 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46825 |
Please comment or provide details below to improve the information on PAYTONS PLACE, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.