Provider Demographics
NPI:1447235072
Name:PALMER, ELYN MCREYNOLDS (LPCC)
Entity Type:Individual
Prefix:MRS
First Name:ELYN
Middle Name:MCREYNOLDS
Last Name:PALMER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 W BROADWAY
Mailing Address - Street 2:STE 1
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240
Mailing Address - Country:US
Mailing Address - Phone:505-393-0692
Mailing Address - Fax:505-393-0796
Practice Address - Street 1:215 W BROADWAY
Practice Address - Street 2:STE 1
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240
Practice Address - Country:US
Practice Address - Phone:505-393-0692
Practice Address - Fax:505-393-0796
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0069192101YM0800X
NM0106311101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health