Provider Demographics
NPI:1407285893
Name:PALERMO, JESSE C (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JESSE
Middle Name:C
Last Name:PALERMO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 W ONONDAGA ST
Mailing Address - Street 2:SUITE 10
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202-1888
Mailing Address - Country:US
Mailing Address - Phone:315-478-2030
Mailing Address - Fax:
Practice Address - Street 1:375 W ONONDAGA ST
Practice Address - Street 2:SUITE 10
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-1888
Practice Address - Country:US
Practice Address - Phone:315-478-2030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-06
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05878800104100000X
NY0856881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker