Provider Demographics
NPI:1356572820
Name:PLAUTZ, DAVID JAMES (PLMHP)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JAMES
Last Name:PLAUTZ
Suffix:
Gender:M
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 PLAZA BLVD
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-4821
Mailing Address - Country:US
Mailing Address - Phone:308-379-2713
Mailing Address - Fax:308-698-0536
Practice Address - Street 1:2315 W 39TH ST
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-8327
Practice Address - Country:US
Practice Address - Phone:308-379-2713
Practice Address - Fax:308-698-0536
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-01
Last Update Date:2009-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8880101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health