Provider Demographics
NPI:1396380689
Name:PALMER, JULIANNA MARILYN (LCSW)
Entity Type:Individual
Prefix:
First Name:JULIANNA
Middle Name:MARILYN
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 1:246 HUNTS NECK RD
Mailing Address - Street 2:
Mailing Address - City:POQUOSON
Mailing Address - State:VA
Mailing Address - Zip Code:23662-1016
Mailing Address - Country:US
Mailing Address - Phone:757-880-7022
Mailing Address - Fax:
Practice Address - Street 1:1720 N KING ST
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23669-1910
Practice Address - Country:US
Practice Address - Phone:757-224-0537
Practice Address - Fax:757-778-2163
Is Sole Proprietor?:No
Enumeration Date:2019-11-11
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040083071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical