Provider Demographics
NPI:1346434255
Name:PALMER, JOAN (LCSW)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
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 1:230-11 141 AVENUE
Mailing Address - Street 2:LAURELTON
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:11413
Mailing Address - Country:US
Mailing Address - Phone:212-337-9290
Mailing Address - Fax:
Practice Address - Street 1:121 W 20TH ST # A
Practice Address - Street 2:NEW YORK,
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-3641
Practice Address - Country:US
Practice Address - Phone:212-337-9290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY075026-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical