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General NPI Number Information
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NPI Number | 1134468754
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Entity Type | Individual
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Provider Name | KENNETH PALMISANO LCSW,LCADC,CCS,CPRS
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Gender | Male
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Dates
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Enumeration Date | 02/01/2013
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Last Update Date | 05/28/2024
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Provider Practice Location Address
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Address Line | 492 ROUTE 57 W
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City | WASHINGTON
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State | NJ
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Zip | 07882-4411
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Country | US
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Telephone | 908-689-1000
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Fax | 908-689-1491
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Provider Business Mailing Address
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Address Line | 492 ROUTE 57 W
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City | WASHINGTON
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State | NJ
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Zip | 07882-4411
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Country | US
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Telephone | 908-689-1000
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Fax | 201-583-7112
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 37CA00106300
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License Number State | NJ
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