Provider Demographics
NPI:1962748822
Name:HANCOX-PALOMO, SHALOME SAIDA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SHALOME
Middle Name:SAIDA
Last Name:HANCOX-PALOMO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SHALOME
Other - Middle Name:SAIDA
Other - Last Name:HANCOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:4300 DECLARATION DR
Mailing Address - Street 2:APT B
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23692-2638
Mailing Address - Country:US
Mailing Address - Phone:325-665-6125
Mailing Address - Fax:
Practice Address - Street 1:713 SW GAYLORD AVE
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-7424
Practice Address - Country:US
Practice Address - Phone:325-665-6125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-21
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
VA09040077391041C0700X
TX522701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical