Active NPI
Jacqueline Renee Palmer
- Mental Health Counselor
- Somerset, PA
National Provider Identifier
1003437674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 245 W Race St
Somerset, PA 15501-1922 - Phone
- (814) 443-4891
- Fax
- (814) 443-6399
- NPI assigned
- May 5, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
245 W Race St
Somerset, PA 15501-1922
Mailing address
245 W Race St
Somerset, PA 15501-1922
Phone (814) 443-4891
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558367185 | Medicaid | PA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Somerset | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588636800000",
"number": "1003437674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "245 W RACE ST",
"city": "SOMERSET",
"state": "PA",
"postal_code": "155011922",
"telephone_number": "814-443-4891",
"fax_number": "814-443-6399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "245 W RACE ST",
"city": "SOMERSET",
"state": "PA",
"postal_code": "155011922",
"telephone_number": "814-443-4891",
"fax_number": "814-443-6399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALMER",
"first_name": "JACQUELINE",
"middle_name": "RENEE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-05",
"last_updated": "2020-05-05",
"certification_date": "2020-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1558367185",
"state": "PA"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Somerset",
"affiliation": "N",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "Somerset",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Somerset",
"address_1": "245 W Race St",
"city": "Somerset",
"state": "PA",
"country_code": "US",
"postal_code": "155011922",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Somerset, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.