Provider Demographics
NPI:1780440032
Name:PALMER, MERCIDES MARTINE (LCPC)
Entity type:Individual
Prefix:MRS
First Name:MERCIDES
Middle Name:MARTINE
Last Name:PALMER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3414 NEWTON ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT RAINIER
Mailing Address - State:MD
Mailing Address - Zip Code:20712-2155
Mailing Address - Country:US
Mailing Address - Phone:202-213-5690
Mailing Address - Fax:
Practice Address - Street 1:3414 NEWTON ST
Practice Address - Street 2:
Practice Address - City:MOUNT RAINIER
Practice Address - State:MD
Practice Address - Zip Code:20712-2155
Practice Address - Country:US
Practice Address - Phone:202-213-5690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC11727101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional