Provider Demographics
NPI:1124073168
Name:PALMER, NOREEN ELLA (MSW LISW)
Entity type:Individual
Prefix:MRS
First Name:NOREEN
Middle Name:ELLA
Last Name:PALMER
Suffix:
Gender:F
Credentials:MSW LISW
Other - Prefix:MISS
Other - First Name:NOREEN
Other - Middle Name:ELLA
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW LISW
Mailing Address - Street 1:7550 SLATE RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-3156
Mailing Address - Country:US
Mailing Address - Phone:614-833-2684
Mailing Address - Fax:614-833-5444
Practice Address - Street 1:7550 SLATE RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-3156
Practice Address - Country:US
Practice Address - Phone:614-833-2684
Practice Address - Fax:614-833-5444
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI0005563104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH7826076OtherAETNA
OH000000350675OtherANTHEM BLUE CROSS AND BLU
OH0112005Medicaid
OH7826076OtherAETNA