MEDICARE: HELEN LOUISE PALMER LMHC

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
1	101YP2500X	Professional Counselor	12954272-6004	UT
2	101YP2500X	Professional Counselor	MH4940	FL
3	101YM0800X	Mental Health Counselor	MH 4940	FL
4	101YP2500X	Professional Counselor	CC6814	ME

General Provider Information

NPI Number	:	1245291681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HELEN LOUISE PALMER LMHC

Provider Business Mailing Address
First Line	:	5118 WAUCHULA RD
Second Line	:
City	:	MYAKKA CITY
State	:	FL
Zip	:	34251-9217
Country	:	US
Telephone Number	:	941-227-3045
Fax Number	:

Provider Business Practice Location Address
First Line	:	5118 WAUCHULA RD
Second Line	:
City	:	MYAKKA CITY
State	:	FL
Zip	:	34251-9217
Country	:	US
Telephone Number	:	941-227-3045
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	01/13/2023

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