Healthcare Provider Details

I. General information

NPI: 1508722075
Provider Name (Legal Business Name): PALM PSYCHOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2025
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1623 E SAINT LOUIS ST
SPRINGFIELD MO
65802-3129
US

IV. Provider business mailing address

1623 E SAINT LOUIS ST
SPRINGFIELD MO
65802-3129
US

V. Phone/Fax

Practice location:
  • Phone: 417-818-4187
  • Fax:
Mailing address:
  • Phone: 417-818-4187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MELODY DARLENE PALM
Title or Position: PSYCHOLOGIST
Credential: PSYD
Phone: 417-818-4187