Provider Demographics
NPI:1134467442
Name:PALMER, ALICE MARIE (LISW-S)
Entity Type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:MARIE
Last Name:PALMER
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:MISS
Other - First Name:ALICE
Other - Middle Name:MARIE
Other - Last Name:SCESNY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:2464 DYSART RD
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-4445
Mailing Address - Country:US
Mailing Address - Phone:216-397-5896
Mailing Address - Fax:
Practice Address - Street 1:24800 HIGHPOINT RD
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-6052
Practice Address - Country:US
Practice Address - Phone:216-831-6611
Practice Address - Fax:216-831-2725
Is Sole Proprietor?:No
Enumeration Date:2013-01-21
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI. 00038921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical