Provider Demographics
NPI:1518945492
Name:PLEMONS, JUDY KATHERINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JUDY
Middle Name:KATHERINE
Last Name:PLEMONS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 62422
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27715-0422
Mailing Address - Country:US
Mailing Address - Phone:919-383-2792
Mailing Address - Fax:919-246-5922
Practice Address - Street 1:2910 UMSTEAD RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27712-2456
Practice Address - Country:US
Practice Address - Phone:919-383-2792
Practice Address - Fax:919-246-5922
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-02
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1013103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC04415OtherBCBS OF NC PROVIDER NO.
NC2816825Medicare ID - Type UnspecifiedPROVIDER NO.