Palmer, Willie
Palmer, Willie is an individual health care provider with primary practice located at 2121A Bellevue Rd , Dublin GA 31021-2998. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Palmer, Willie can be contacted via phone (478) 272-1190.Contact Information
Primary practice address
2121A Bellevue Rd
Dublin GA 31021-2998
Phone: (478) 272-1190
Fax: (478) 274-7628
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X | LPC005494 | Georgia |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | LPC005494 | Georgia |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | LPC005494 | Georgia |
Profile Details
| NPI number | 1689902769 |
|---|---|
| LBN Legal business name | Palmer, Willie |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 30th, 2009 |
| Last updated | Jun 23rd, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689902769 | NPPES |
| Georgia | MEDICAID | 300030912A |
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