Provider Demographics
NPI:1992844955
Name:PLUNK, NANCY R (LPC/MHSP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:R
Last Name:PLUNK
Suffix:
Gender:F
Credentials:LPC/MHSP
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:CLENNEY
Other - Last Name:HARRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC/MHSP
Mailing Address - Street 1:142 OLD BELLS LOOP
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-9609
Mailing Address - Country:US
Mailing Address - Phone:731-697-7185
Mailing Address - Fax:
Practice Address - Street 1:26 LAMAR CIRCLE
Practice Address - Street 2:SUITE 3
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-1528
Practice Address - Country:US
Practice Address - Phone:731-697-7185
Practice Address - Fax:731-736-2530
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2682101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ016792Medicaid