Provider Demographics
NPI:1265949382
Name:PALMER, SARAH JANE (MS, LPC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JANE
Last Name:PALMER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:PALMER
Other - Last Name:RYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPCC
Mailing Address - Street 1:4629 AICHOLTZ RD.
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45244
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4633 AICHOLTZ RD.
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45244-4524
Practice Address - Country:US
Practice Address - Phone:513-300-6171
Practice Address - Fax:513-300-6171
Is Sole Proprietor?:No
Enumeration Date:2018-01-10
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1901806101YM0800X
171M00000X
OHE.2102567101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator