Provider Demographics
NPI:1851667679
Name:PLYMPTON, KATHRYN COOMBS (LPC-A)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:COOMBS
Last Name:PLYMPTON
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 COVIL AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-2683
Mailing Address - Country:US
Mailing Address - Phone:910-332-5734
Mailing Address - Fax:
Practice Address - Street 1:503 COVIL AVENUE
Practice Address - Street 2:SUITE 102
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403
Practice Address - Country:US
Practice Address - Phone:910-332-5734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-26
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA9446101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health