Provider Demographics
NPI:1144370396
Name:PALMER, KIMBERLY (LCSW)
Entity type:Individual
Prefix:MISS
First Name:KIMBERLY
Middle Name:
Last Name:PALMER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KYM
Other - Middle Name:
Other - Last Name:PALMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:100 S UNIVERSITY AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5215
Mailing Address - Country:US
Mailing Address - Phone:501-664-9050
Mailing Address - Fax:501-296-9323
Practice Address - Street 1:100 S UNIVERSITY AVE STE 200
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5215
Practice Address - Country:US
Practice Address - Phone:501-664-9050
Practice Address - Fax:501-296-9323
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1263-C104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker