Provider Demographics
NPI:1730111006
Name:PALMER, KATHY M (MSW,LMSW)
Entity Type:Individual
Prefix:MS
First Name:KATHY
Middle Name:M
Last Name:PALMER
Suffix:
Gender:F
Credentials:MSW,LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1171 ARCLAIR
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48638
Mailing Address - Country:US
Mailing Address - Phone:989-245-3721
Mailing Address - Fax:989-391-5149
Practice Address - Street 1:5090 STATE ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603
Practice Address - Country:US
Practice Address - Phone:989-245-3721
Practice Address - Fax:989-391-5149
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIKP072545104100000X
MI68010725451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0996507OtherHEALTH PLUS
MI8008953460OtherBCBSM