Provider Demographics
NPI:1760007728
Name:PALMER, JESSALYN (NCC, LPC)
Entity Type:Individual
Prefix:
First Name:JESSALYN
Middle Name:
Last Name:PALMER
Suffix:
Gender:F
Credentials:NCC, LPC
Other - Prefix:
Other - First Name:JESSALYN
Other - Middle Name:
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NCC, LPC
Mailing Address - Street 1:1010 BAY POINTE XING
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-6955
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1010 BAY POINTE XING
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-6955
Practice Address - Country:US
Practice Address - Phone:404-862-8483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005523101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional