Provider Demographics
NPI:1639848435
Name:PALMER, BROOKLYN (LPCC)
Entity type:Individual
Prefix:
First Name:BROOKLYN
Middle Name:
Last Name:PALMER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7061 TRACY CREEK DR APT 2B
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-7437
Mailing Address - Country:US
Mailing Address - Phone:937-707-7228
Mailing Address - Fax:
Practice Address - Street 1:7061 TRACY CREEK DR APT 2B
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-7437
Practice Address - Country:US
Practice Address - Phone:937-707-7228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-07
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
OHE.2505513101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health