Provider Demographics
NPI:1023564887
Name:PLUMER, LINDSAY ALLYN YATES (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:ALLYN YATES
Last Name:PLUMER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:ALLYN
Other - Last Name:YATES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:712 HORACE AVE N
Mailing Address - Street 2:
Mailing Address - City:THIEF RIVER FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56701-1626
Mailing Address - Country:US
Mailing Address - Phone:203-207-1940
Mailing Address - Fax:
Practice Address - Street 1:112 1ST ST W
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-4002
Practice Address - Country:US
Practice Address - Phone:218-888-8032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-31
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP6308103T00000X
390200000X
MNLP3608103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program