Provider Demographics
NPI:1538105341
Name:PALLMEYER, THOMAS P (PHD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:P
Last Name:PALLMEYER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2741 LITITZ PIKE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601
Mailing Address - Country:US
Mailing Address - Phone:717-569-8511
Mailing Address - Fax:717-569-8513
Practice Address - Street 1:2741 LITITZ PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601
Practice Address - Country:US
Practice Address - Phone:717-569-8511
Practice Address - Fax:717-569-8513
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005853L103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2057144OtherCIGAN BEHAV HEALTH
PA281546OtherMAMSI
PA455934000OtherMAGELLAN
PA03210301OtherCAPITAL BLUE CROSS
PA1381980OtherPA BLUE SHIELD
PA109431OtherVALUE OPTIONS
PA61607401OtherCAREFIRST BC/BS OF MARYLA
PAR06582Medicare UPIN
PA1929506Medicare PIN