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General NPI Number Information
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NPI Number | 1962256925
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Entity Type | Individual
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Provider Name | MATTHEW LUKE STONE PALMER LCSW
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Gender | Male
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Dates
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Enumeration Date | 04/16/2024
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 1449 S MICHIGAN AVE # 1054
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City | CHICAGO
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State | IL
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Zip | 60605-2810
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Country | US
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Telephone | 312-292-9818
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Fax |
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Provider Business Mailing Address
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Address Line | 1228 QUIGLEY PL
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City | SOUTH BEND
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State | IN
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Zip | 46617-4405
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Country | US
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Telephone | 812-419-2637
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Fax | 812-694-3834
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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 | Q5-0000182
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 133788
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 089.0135999TELE
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License Number State | VT
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149028558
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | TLS969CP
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License Number State | SC
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Taxonomy #6
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34011307A
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License Number State | IN
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Taxonomy #7
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 12030-123
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License Number State | WI
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Taxonomy #8
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4461974
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License Number State | ID
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Taxonomy #9
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | TPSW4390
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License Number State | FL
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