Active NPI
Kelli Rebecca Palmer, M.A., ED.S.
- School Psychologist
- Niles, OH
National Provider Identifier
1881058030
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 21145306
- Practice address
- 6000 Youngstown Warren Rd
Niles, OH 44446-4624 - Phone
- (330) 505-2800
- NPI assigned
- Apr 13, 2016
- 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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 21145306 | OH | Primary |
Addresses
Primary practice location
6000 Youngstown Warren Rd
Niles, OH 44446-4624
Mailing address
1071 Beechwood Dr
Girard, OH 44420-2105
Phone (330) 402-7030
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21145306 | OH | MD | School Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trumbull County Educational Service Center | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Local Education Agency (LEA)
- Niles, OH
- NPI 1164661302
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460505600000",
"number": "1881058030",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1071 BEECHWOOD DR",
"city": "GIRARD",
"state": "OH",
"postal_code": "444202105",
"telephone_number": "330-402-7030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6000 YOUNGSTOWN WARREN RD",
"city": "NILES",
"state": "OH",
"postal_code": "444464624",
"telephone_number": "330-505-2800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALMER",
"first_name": "KELLI",
"middle_name": "REBECCA",
"name_prefix": "Mrs.",
"credential": "M.A., ED.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-13",
"last_updated": "2016-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "OH",
"license": "21145306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Niles, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.