Healthcare Provider Details

I. General information

NPI: 1902415433
Provider Name (Legal Business Name): VERNON TERRY PALMER LPC/MHSP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2020
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

352 LANTANA RD
CROSSVILLE TN
38555-4900
US

IV. Provider business mailing address

113 FRANKLIN VILLAGE TRCE
KINGSTON TN
37763-2614
US

V. Phone/Fax

Practice location:
  • Phone: 931-208-0865
  • Fax:
Mailing address:
  • Phone: 865-307-4917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number5317
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number5317
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5317
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5317
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: