Provider Demographics
NPI:1629139860
Name:PLIMPTON, EDWARD H (PHD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:H
Last Name:PLIMPTON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 N PLEASANT ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-1736
Mailing Address - Country:US
Mailing Address - Phone:413-253-1482
Mailing Address - Fax:413-253-1482
Practice Address - Street 1:256 N PLEASANT ST
Practice Address - Street 2:SUITE 4
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-1736
Practice Address - Country:US
Practice Address - Phone:413-253-1482
Practice Address - Fax:413-253-1482
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3874103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW50923Medicaid
MAW03876OtherBLUE CROSS BLUE SHIELD
MA15468OtherHEALTH NEW ENGLAND