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General NPI Number Information
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NPI Number | 1376295238
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Entity Type | Individual
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Provider Name | ODARIS PALACIOS LMHC
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Gender | Female
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Dates
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Enumeration Date | 01/21/2022
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 347 5TH AVE RM 610
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City | NEW YORK
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State | NY
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Zip | 10016-5004
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Country | US
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Telephone | 646-450-6778
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Fax |
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Provider Business Mailing Address
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Address Line | 5956 MADISON ST APT 3F
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City | RIDGEWOOD
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State | NY
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Zip | 11385-3906
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Country | US
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Telephone | 516-508-3611
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 016604
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License Number State | NY
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