Provider Demographics
NPI:1760967202
Name:PALMER, THENESSA MACK (LPC)
Entity Type:Individual
Prefix:MRS
First Name:THENESSA
Middle Name:MACK
Last Name:PALMER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:THENESSA
Other - Middle Name:
Other - Last Name:MACK-PALMER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2909 TURNER WARNELL RD STE 131
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76001-7746
Mailing Address - Country:US
Mailing Address - Phone:682-593-2530
Mailing Address - Fax:
Practice Address - Street 1:2909 TURNER WARNELL RD # 131
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76001-7727
Practice Address - Country:US
Practice Address - Phone:817-969-5114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-01
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73775101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional