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General NPI Number Information
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NPI Number | 1417163882
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Entity Type | Organization
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Legal Business Name | PALMER COUNSELING, LLC
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1039 W MASON ST
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City | GREEN BAY
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State | WI
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Zip | 54303-1842
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Country | US
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Telephone | 920-819-0865
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Fax |
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Provider Business Mailing Address
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Address Line | 1039 W MASON ST
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City | GREEN BAY
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State | WI
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Zip | 54303-1842
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Country | US
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Telephone | 920-819-0865
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Fax |
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Authorized Official
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Title or Position | OWNER, PSYCHOTHERAPIST
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Name | MR. JEFFREY LAWRENCE PALMER
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Credential | LCSW, MSW
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Telephone | 920-819-0865
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 6948-123
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License Number State | WI
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