Provider Demographics
NPI:1780456517
Name:PALMER, HEATHER LEONA (LMSW)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:LEONA
Last Name:PALMER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 MALDEN BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NASSAU
Mailing Address - State:NY
Mailing Address - Zip Code:12123-2004
Mailing Address - Country:US
Mailing Address - Phone:917-703-2767
Mailing Address - Fax:
Practice Address - Street 1:430 E ALLEN ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-2576
Practice Address - Country:US
Practice Address - Phone:518-945-8584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1216941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical