Provider Demographics
NPI:1417467580
Name:PLUMMER, JOSHUA BARRY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:BARRY
Last Name:PLUMMER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 MENDON RD UNIT 42
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-6234
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2 REGENCY PLZ STE 12
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-3143
Practice Address - Country:US
Practice Address - Phone:401-421-1405
Practice Address - Fax:401-331-8223
Is Sole Proprietor?:No
Enumeration Date:2017-10-03
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS01807103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist