Provider Demographics
NPI:1154679595
Name:PALMER, WILLIAM (LCSW, BCD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:PALMER
Suffix:
Gender:M
Credentials:LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 NATOMA ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-2658
Mailing Address - Country:US
Mailing Address - Phone:916-850-0292
Mailing Address - Fax:916-281-3951
Practice Address - Street 1:31 NATOMA ST
Practice Address - Street 2:SUITE 110
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-2658
Practice Address - Country:US
Practice Address - Phone:916-850-0292
Practice Address - Fax:916-281-3951
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA201341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical