Provider Demographics
NPI:1073884086
Name:PALMER, SHERIE JOY (LCSW)
Entity Type:Individual
Prefix:
First Name:SHERIE
Middle Name:JOY
Last Name:PALMER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4174 LAKE PARK AVE
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-3033
Mailing Address - Country:US
Mailing Address - Phone:847-244-9850
Mailing Address - Fax:
Practice Address - Street 1:4174 LAKE PARK AVE
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-3033
Practice Address - Country:US
Practice Address - Phone:847-244-9850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-23
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0007631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical