Healthcare Provider Details

I. General information

NPI: 1083528913
Provider Name (Legal Business Name): MARIA KATHLEEN PALERMO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 WALNUT ST STE 802
PHILADELPHIA PA
19107-4708
US

IV. Provider business mailing address

6730 PECHIN ST
PHILADELPHIA PA
19128-4537
US

V. Phone/Fax

Practice location:
  • Phone: 215-668-9356
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: