Provider Demographics
NPI:1710395629
Name:PALMER, KELSEY (NCC, LPC-MH, LMFT)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:PALMER
Suffix:
Gender:F
Credentials:NCC, LPC-MH, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 KANSAS AVE SE
Mailing Address - Street 2:
Mailing Address - City:HURON
Mailing Address - State:SD
Mailing Address - Zip Code:57350-2517
Mailing Address - Country:US
Mailing Address - Phone:605-352-8596
Mailing Address - Fax:605-352-7001
Practice Address - Street 1:357 KANSAS AVE SE
Practice Address - Street 2:
Practice Address - City:HURON
Practice Address - State:SD
Practice Address - Zip Code:57350-2517
Practice Address - Country:US
Practice Address - Phone:053-528-5966
Practice Address - Fax:605-352-7001
Is Sole Proprietor?:No
Enumeration Date:2014-07-24
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLMFT1231106H00000X
SDLPC-MH30504101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1710395629OtherWELLMARK
SD1710395629OtherAETNA
SD1710395629OtherWELLCARE
SD1710395629OtherCIGNA HEALTH
SD1710395629OtherUNITEDHEALTHCARE
SD1710395629OtherDAKOTA CARE
SD1710395629Medicaid
SD1710395629OtherBLUE CROSS BLUE SHIELD
SD1710395629OtherAVERA HEALTH
SD1710395629OtherSTANFORD INSURANCE