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NPI Code Detail

MEDICARE: SARA PALMER BS, QMHS, CDCA

MEDICARE: SARA PALMER BS, QMHS, CDCA
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
1101YA0400XAddiction (Substance Use Disorder) CounselorCDCA.172143OH

General Provider Information

NPI Number : 1194505149
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA PALMER BS, QMHS, CDCA
Provider Business Mailing Address
First Line : 2285 BENDEN DR
Second Line :
City : WOOSTER
State : OH
Zip : 44691-2568
Country : US
Telephone Number : 330-264-9002
Fax Number :
Provider Business Practice Location Address
First Line : 475 LEXINGTON AVE
Second Line :
City : MANSFIELD
State : OH
Zip : 44907-1501
Country : US
Telephone Number : 419-419-5705
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2023
Last Update Date : 01/23/2026

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