Provider Demographics
NPI:1689785065
Name:PALMER, ANN L (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:L
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 1:80 5TH AVENUE
Mailing Address - Street 2:SUITE 903
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8018
Mailing Address - Country:US
Mailing Address - Phone:212-838-3855
Mailing Address - Fax:646-486-4966
Practice Address - Street 1:80 5TH AVENUE
Practice Address - Street 2:SUITE 903
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8018
Practice Address - Country:US
Practice Address - Phone:212-838-3855
Practice Address - Fax:646-486-4966
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR02512411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
145494OtherVALUE OPTIONS
4538076OtherAETNA
145494OtherVALUE OPTIONS