Healthcare Provider Details

I. General information

NPI: 1659738979
Provider Name (Legal Business Name): RICKIE PALMER LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2016
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 MOUNTAIN RD NW
ALBUQUERQUE NM
87104-1359
US

IV. Provider business mailing address

1500 MOUNTAIN RD NW
ALBUQUERQUE NM
87104-1359
US

V. Phone/Fax

Practice location:
  • Phone: 505-557-4656
  • Fax: 505-514-0874
Mailing address:
  • Phone: 505-557-4656
  • Fax: 505-514-0874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCCMH0178511
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: