Healthcare Provider Details

I. General information

NPI: 1922146737
Provider Name (Legal Business Name): RASEL L. PALMER LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: REESE L. PALMER LMFT

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7201 BROOKFIELD RD
COLUMBIA SC
29223-2215
US

IV. Provider business mailing address

7201 BROOKFIELD RD
COLUMBIA SC
29223-2215
US

V. Phone/Fax

Practice location:
  • Phone: 803-722-4975
  • Fax: 803-722-6018
Mailing address:
  • Phone: 803-722-4975
  • Fax: 803-722-6018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number37FI0017990
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: