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NPI Code Detail

MEDICARE: KELLI SPENCER PALMER LCSW

MEDICARE: KELLI SPENCER 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
11041C0700XClinical Social Worker0904012696VA

General Provider Information

NPI Number : 1265000426
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLI SPENCER PALMER LCSW
Provider Business Mailing Address
First Line : 22 E CHURCH ST STE 310
Second Line :
City : MARTINSVILLE
State : VA
Zip : 24112-6208
Country : US
Telephone Number : 276-340-6195
Fax Number :
Provider Business Practice Location Address
First Line : 22 E CHURCH ST STE 310
Second Line :
City : MARTINSVILLE
State : VA
Zip : 24112-6208
Country : US
Telephone Number : 276-340-6195
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2021
Last Update Date : 01/08/2024

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Directions to “ KELLI SPENCER PALMER LCSW” Practice Location

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