Jacqueline D. Payne | Memphis, TN • PECOS Search

Jacqueline D. Payne

Social Worker

Behavioral Health & Social Service Providers

1265 Union Ave, Memphis, TN 38104-3415

(901) 516-8087 (901) 368-0649

PECOS Enrollment

Based on the most recent information from CMS, provider Jacqueline D. Payne does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1396889812
Provider Type
Individual
Full Name
Payne, Jacqueline D.
Title
Miss
Credential
MSW

Gender
Female
Sole Proprietor
Yes
Enumeration Date
2/17/2007
Last Updated
7/8/2007

Contact Information

Practice Location

1265 Union Ave, Memphis, TN 38104-3415

(901) 516-8198

Mailing Location

4714 Scottsdale Ave, Memphis, TN 38118-4359

(901) 516-8198

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License CSW0000004195 Tennessee