Provider Demographics
NPI:1689804189
Name:DAVID A. PLANK, L.C.S.W., P.A.
Entity Type:Organization
Organization Name:DAVID A. PLANK, L.C.S.W., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:PLANK
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:336-833-3253
Mailing Address - Street 1:PO BOX 41201
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27404-1201
Mailing Address - Country:US
Mailing Address - Phone:336-833-3253
Mailing Address - Fax:336-274-4299
Practice Address - Street 1:608 N GREENE ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-2024
Practice Address - Country:US
Practice Address - Phone:336-833-3253
Practice Address - Fax:336-274-4299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-17
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0029261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC73978OtherMEDCOST
NC1243AOtherBLUE CROSS BLUE SHIELD