Provider Demographics
NPI:1881980688
Name:PALMER, CYNTHIA SPIRIDOULA (LCPC)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:SPIRIDOULA
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 1:821 NORTH 27TH STREET, PMB 152
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-1121
Mailing Address - Country:US
Mailing Address - Phone:406-231-8912
Mailing Address - Fax:
Practice Address - Street 1:2680 OVERLAND AVE STE C
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-7411
Practice Address - Country:US
Practice Address - Phone:406-231-8912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-21
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1571101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000746820OtherBLUE CROSS-SHIELD OF MONTANA