Provider Demographics
NPI:1972742013
Name:PALMER, LISA C (PHD, LMFT, CHT)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:C
Last Name:PALMER
Suffix:
Gender:F
Credentials:PHD, LMFT, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:499 E PALMETTO PARK RD STE 206
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-5081
Mailing Address - Country:US
Mailing Address - Phone:954-907-3446
Mailing Address - Fax:
Practice Address - Street 1:499 E PALMETTO PARK RD STE 206
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-5081
Practice Address - Country:US
Practice Address - Phone:954-907-3446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-12
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2224101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health