Provider Demographics
NPI:1275735912
Name:PALMER, CASSANDRA A (MS, LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:A
Last Name:PALMER
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 BANYAN RD
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-4326
Mailing Address - Country:US
Mailing Address - Phone:662-312-2922
Mailing Address - Fax:
Practice Address - Street 1:101 S LAFAYETTE ST
Practice Address - Street 2:SUITE 19
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-2914
Practice Address - Country:US
Practice Address - Phone:662-338-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1128101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional