Provider Demographics
NPI:1790377596
Name:PALMER, KARLA LEIGH (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:LEIGH
Last Name:PALMER
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 KAREN CIR
Mailing Address - Street 2:
Mailing Address - City:WHITE ROCK
Mailing Address - State:NM
Mailing Address - Zip Code:87547-3797
Mailing Address - Country:US
Mailing Address - Phone:505-709-7403
Mailing Address - Fax:
Practice Address - Street 1:1505 15TH ST STE C
Practice Address - Street 2:
Practice Address - City:LOS ALAMOS
Practice Address - State:NM
Practice Address - Zip Code:87544-3000
Practice Address - Country:US
Practice Address - Phone:505-662-4160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-03
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCMH0215471101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health