Provider Demographics
NPI:1538771282
Name:PALMER, FAITH MARIE (CDCA)
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:MARIE
Last Name:PALMER
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2861 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-6263
Mailing Address - Country:US
Mailing Address - Phone:330-980-2353
Mailing Address - Fax:234-312-9579
Practice Address - Street 1:2703 MAHONING AVE STE 105
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44509-2337
Practice Address - Country:US
Practice Address - Phone:330-781-5107
Practice Address - Fax:234-312-9579
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)