Provider Demographics
NPI:1912661125
Name:PALMER-BAKERSMITH, EMILEE LYNN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:EMILEE
Middle Name:LYNN
Last Name:PALMER-BAKERSMITH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MISS
Other - First Name:EMILEE
Other - Middle Name:LYNN
Other - Last Name:PALMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PLPC
Mailing Address - Street 1:406 N SPRING ST STE 2
Mailing Address - Street 2:
Mailing Address - City:PERRYVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63775-1912
Mailing Address - Country:US
Mailing Address - Phone:573-547-8305
Mailing Address - Fax:573-547-8306
Practice Address - Street 1:402 S SILVER SPRINGS RD
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-7536
Practice Address - Country:US
Practice Address - Phone:573-334-1100
Practice Address - Fax:573-547-8306
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO490103001Medicaid