Provider Demographics
NPI:1629898481
Name:PALMER, JASMINE O (LCSW)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:O
Last Name:PALMER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 W 246TH ST APT 234
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-3632
Mailing Address - Country:US
Mailing Address - Phone:347-782-1253
Mailing Address - Fax:
Practice Address - Street 1:630 W 246TH ST APT 234
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10471-3632
Practice Address - Country:US
Practice Address - Phone:347-782-1253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0855611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical