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NPI Code Detail

MEDICARE: ACACIA PALMER LCSW

MEDICARE:   ACACIA  PALMER  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker095971-1NY
21041C0700XClinical Social Worker100613NY

General Provider Information

NPI Number : 1104355593
Entity Type Code : Individual
Provider Name (Legal Business Name) : ACACIA PALMER LCSW
Provider Business Mailing Address
First Line : 167 MADISON AVENUE
Second Line : SUITE 205 #515
City : NEW YORK
State : NY
Zip : 10016
Country : US
Telephone Number : 917-617-2013
Fax Number :
Provider Business Practice Location Address
First Line : 3635 BELL BLVD STE 203
Second Line :
City : BAYSIDE
State : NY
Zip : 11361-2097
Country : US
Telephone Number : 718-504-9256
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2017
Last Update Date : 08/04/2025

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Directions to “ ACACIA PALMER LCSW” Practice Location

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