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Individual

CHARLES MATTHEW PLUMMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
710 S HOLLY ST, SILOAM SPRINGS, AR 72761-3304
(479) 750-2020
(479) 524-5197
Mailing address
PO BOX 6433, SPRINGDALE, AR 72766-6433
(479) 750-2020
(479) 524-5197

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C1270
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5U713
BLUE SHEILD PROVIDER #
AR
Enumeration date
06/30/2006
Last updated
07/08/2007
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