Provider Demographics
NPI:1922261940
Name:JANGDHARRIE-PALMER, ROSALYN SAVETRI (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:ROSALYN
Middle Name:SAVETRI
Last Name:JANGDHARRIE-PALMER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8905 MIDDLEBROOK CT
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-4145
Mailing Address - Country:US
Mailing Address - Phone:410-655-7379
Mailing Address - Fax:
Practice Address - Street 1:8905 MIDDLEBROOK CT
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-4145
Practice Address - Country:US
Practice Address - Phone:410-655-7379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD046041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4040830-00Medicaid