Provider Demographics
NPI:1215828066
Name:NICOLE PLUMMER LLC
Entity type:Organization
Organization Name:NICOLE PLUMMER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:PLUMMER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:479-899-5448
Mailing Address - Street 1:707 N CREEKWOOD RD
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-3112
Mailing Address - Country:US
Mailing Address - Phone:479-899-5448
Mailing Address - Fax:
Practice Address - Street 1:3401 SE MACY RD STE 14
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-7843
Practice Address - Country:US
Practice Address - Phone:479-899-5448
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty