Healthcare Provider Details

I. General information

NPI: 1447144118
Provider Name (Legal Business Name): PALMER MAHAL MA, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2025
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5303 SPINE RD UNIT 202B
BOULDER CO
80301-3344
US

IV. Provider business mailing address

5303 SPINE RD UNIT 202B
BOULDER CO
80301-3344
US

V. Phone/Fax

Practice location:
  • Phone: 720-295-6432
  • Fax:
Mailing address:
  • Phone: 720-295-6432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC.0023347
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: