Provider Demographics
NPI:1609218858
Name:PLANTE, JAMES DAVID (LCSW)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:DAVID
Last Name:PLANTE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 TIFT ST
Mailing Address - Street 2:
Mailing Address - City:GRISWOLD
Mailing Address - State:CT
Mailing Address - Zip Code:06351-1821
Mailing Address - Country:US
Mailing Address - Phone:860-908-5270
Mailing Address - Fax:
Practice Address - Street 1:59 TIFT ST
Practice Address - Street 2:
Practice Address - City:GRISWOLD
Practice Address - State:CT
Practice Address - Zip Code:06351-1821
Practice Address - Country:US
Practice Address - Phone:860-908-5270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-29
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0082391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical