Provider Demographics
NPI:1508045436
Name:PALAMARA, DEAN ANTHONY (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DEAN
Middle Name:ANTHONY
Last Name:PALAMARA
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 1:5986 HERON POND DR
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32128-7214
Mailing Address - Country:US
Mailing Address - Phone:386-767-2436
Mailing Address - Fax:
Practice Address - Street 1:5986 HERON POND DR
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32128-7214
Practice Address - Country:US
Practice Address - Phone:386-767-2436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-27
Last Update Date:2007-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL8404101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional