Provider Demographics
NPI:1477223006
Name:PALMER, SARAH M (LPC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:M
Last Name:PALMER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:387 GOSHEN CHURCH WAY
Mailing Address - Street 2:
Mailing Address - City:WALESKA
Mailing Address - State:GA
Mailing Address - Zip Code:30183-2347
Mailing Address - Country:US
Mailing Address - Phone:770-595-0442
Mailing Address - Fax:
Practice Address - Street 1:200 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-2745
Practice Address - Country:US
Practice Address - Phone:770-595-0442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA012377101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional