Provider Demographics
NPI:1881650216
Name:PALMIERI, JESSICA L (LSW)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:L
Last Name:PALMIERI
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 1 BOX 137
Mailing Address - Street 2:
Mailing Address - City:TOWANDA
Mailing Address - State:PA
Mailing Address - Zip Code:18848-9730
Mailing Address - Country:US
Mailing Address - Phone:570-265-0100
Mailing Address - Fax:570-268-2756
Practice Address - Street 1:RR 1 BOX 137
Practice Address - Street 2:
Practice Address - City:TOWANDA
Practice Address - State:PA
Practice Address - Zip Code:18848-9730
Practice Address - Country:US
Practice Address - Phone:570-265-0100
Practice Address - Fax:570-268-2756
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
PASW127647104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)