Provider Demographics
NPI:1194561852
Name:PALMER, RACHEL SADIE (MA, LAC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:SADIE
Last Name:PALMER
Suffix:
Gender:F
Credentials:MA, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 E MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-3162
Mailing Address - Country:US
Mailing Address - Phone:973-919-7491
Mailing Address - Fax:
Practice Address - Street 1:247 E MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-3162
Practice Address - Country:US
Practice Address - Phone:973-919-7491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00759600101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor