Provider Demographics
NPI:1174053714
Name:PALACIO, CLAUDIA (LSW)
Entity type:Individual
Prefix:MS
First Name:CLAUDIA
Middle Name:
Last Name:PALACIO
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:CLAUDIA
Other - Middle Name:
Other - Last Name:PALACIOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:8941 ALTON ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-4537
Mailing Address - Country:US
Mailing Address - Phone:267-212-4517
Mailing Address - Fax:
Practice Address - Street 1:85 EAST LOGAN ST.
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144
Practice Address - Country:US
Practice Address - Phone:215-438-2414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-15
Last Update Date:2017-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW132781104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker