Individual provider Active NPI

Laurie D Palmer, LCSW

  • Clinical Social Worker
  • Jasper, GA
National Provider Identifier
1053639815
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW004112 Issued in GA
Practice address
630 E Church St
Jasper, GA 30143-1312
Phone
(762) 233-4869
Fax
(706) 510-2654
NPI assigned
May 4, 2010
Last updated
Mar 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW004112 GA Primary

Addresses

Primary practice location

630 E Church St
Jasper, GA 30143-1312

Mailing address

630 E Church St
Jasper, GA 30143-1312
Phone (770) 345-2230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250207000597 GA Practitioner - Clinical Social Worker 8123558020 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Family Therapy, LLCGroup PAC ID 5092101410, 2 clinicians

Practice addresses (Care Compare)

630 E Church St
Jasper, GA 30143-1312
Phone (762) 233-4869

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW004112GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
United Family Therapy, LLC Clinical CurrentSince Nov 1, 2024 Accepting new patients

Locations

9 Russell Dr
Ste 201
Ellijay, GA 30540
Phone (706) 636-4000

630 E Church St
Jasper, GA 30143
Phone (762) 233-4869

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1272931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1053639815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 E CHURCH ST",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301431312",
            "telephone_number": "770-345-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 E CHURCH ST",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301431312",
            "telephone_number": "762-233-4869",
            "fax_number": "706-510-2654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "LAURIE",
        "middle_name": "D",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-04",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, GA

Sources for this page

Verify at the official NPI Registry.