Provider Demographics
NPI:1750894267
Name:PLUM, PATRICIA ANN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANN
Last Name:PLUM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30140 W LYNWOOD ST
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85396-5392
Mailing Address - Country:US
Mailing Address - Phone:623-256-7539
Mailing Address - Fax:
Practice Address - Street 1:250 N LITCHFIELD RD STE 201
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-1372
Practice Address - Country:US
Practice Address - Phone:623-337-2275
Practice Address - Fax:623-800-7626
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-07
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-151761041C0700X
AZLCSW-169621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical