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NPI Code Detail

MEDICARE: KARIN LYNN PALOMBELLA MA LPC NCC

MEDICARE: KARIN LYNN PALOMBELLA MA LPC NCC
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
1101YP2500XProfessional Counselor6401007819MI
2101Y00000XCounselor6401007819MI

General Provider Information

NPI Number : 1356411722
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARIN LYNN PALOMBELLA MA LPC NCC
Provider Business Mailing Address
First Line : 18021 28 MILE RD
Second Line :
City : RAY
State : MI
Zip : 48096-2942
Country : US
Telephone Number : 586-531-8668
Fax Number :
Provider Business Practice Location Address
First Line : 13001 23 MILE RD STE 103
Second Line :
City : SHELBY TOWNSHIP
State : MI
Zip : 48315-2767
Country : US
Telephone Number : 800-693-1916
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2006
Last Update Date : 08/31/2018

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