Ida McNear Palmer, CADCII

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1415 Issued in GA

Practice address

501 Gloucester St Ste 207
Brunswick, GA 31520-7002

Phone

(912) 506-6910

NPI assigned

Mar 16, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1584316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1689200271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 SPRINGDALE RD",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204836",
            "telephone_number": "912-506-6910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 GLOUCESTER ST STE 207",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315207002",
            "telephone_number": "912-506-6910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "IDA",
        "middle_name": "MCNEAR",
        "name_prefix": "Ms.",
        "credential": "CADCII",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-16",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": "1415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "thelighthouseproject@51",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "501 Gloucester St. Ste. 207, Brunswick, GA 31520-7002",
            "address_1": "501 Gloucester St Ste 207",
            "city": "Brunswick",
            "state": "GA",
            "country_code": "US",
            "postal_code": "315207002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Brunswick, GA
• Addiction (Substance Use Disorder) Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.

Verify at the official NPI Registry.