Provider Demographics
NPI:1245317817
Name:PALMER, VAN SWENSON (LCSW)
Entity type:Individual
Prefix:MR
First Name:VAN
Middle Name:SWENSON
Last Name:PALMER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3437 S HERITAGE ST
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-8802
Mailing Address - Country:US
Mailing Address - Phone:559-739-1527
Mailing Address - Fax:559-627-3775
Practice Address - Street 1:1910 S COURT ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-5426
Practice Address - Country:US
Practice Address - Phone:559-627-3775
Practice Address - Fax:559-627-8444
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS17048106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist