Healthcare Provider Details

I. General information

NPI: 1790672558
Provider Name (Legal Business Name): JOSEPH PALUMBO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2025
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

637 MORTON BLVD
HAZARD KY
41701-9474
US

IV. Provider business mailing address

115 ROCKWOOD LN
HAZARD KY
41701-9415
US

V. Phone/Fax

Practice location:
  • Phone: 606-223-2866
  • Fax:
Mailing address:
  • Phone: 606-436-5761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: