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General NPI Number Information
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NPI Number | 1932853405
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Entity Type | Individual
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Provider Name | ALYSSA PLUNKETT LMSW
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Gender | Female
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Dates
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Enumeration Date | 02/03/2022
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Last Update Date | 02/03/2022
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Provider Practice Location Address
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Address Line | 617 FRANKLIN ST STE 201
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City | PELLA
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State | IA
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Zip | 50219-1685
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Country | US
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Telephone | 319-784-8221
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 399
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City | BAXTER
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State | IA
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Zip | 50028-0399
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Country | US
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Telephone | 319-784-8221
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 077354
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License Number State | IA
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