MEDICARE: JOAN 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
1	1041C0700X	Clinical Social Worker	075026-1	NY

General Provider Information

NPI Number	:	1346434255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOAN PALMER LCSW

Provider Business Mailing Address
First Line	:	230-11 141 AVENUE
Second Line	:	LAURELTON
City	:	NEW YORK
State	:	NY
Zip	:	11413
Country	:	US
Telephone Number	:	212-337-9290
Fax Number	:

Provider Business Practice Location Address
First Line	:	121 W 20TH ST # A
Second Line	:	NEW YORK,
City	:	NEW YORK
State	:	NY
Zip	:	10011-3641
Country	:	US
Telephone Number	:	212-337-9290
Fax Number	:

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

Provider Enumeration Date	:	09/04/2007
Last Update Date	:	09/04/2007

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Directions to “ JOAN PALMER LCSW” Practice Location

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