Provider Demographics
NPI:1982421764
Name:PALLO, KERSTIN (LCSW)
Entity type:Individual
Prefix:
First Name:KERSTIN
Middle Name:
Last Name:PALLO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 SOUTHERN AVE
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:MA
Mailing Address - Zip Code:01929-1404
Mailing Address - Country:US
Mailing Address - Phone:973-851-3755
Mailing Address - Fax:
Practice Address - Street 1:133 BRIMBAL AVE STE E
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-1856
Practice Address - Country:US
Practice Address - Phone:978-921-2052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2245381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical