Provider Demographics
NPI:1649347287
Name:PLYMALE, WILLIAM SCOTT (LCSW, PHD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:SCOTT
Last Name:PLYMALE
Suffix:
Gender:M
Credentials:LCSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 ETHEL AVE
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-2787
Mailing Address - Country:US
Mailing Address - Phone:415-310-4866
Mailing Address - Fax:
Practice Address - Street 1:17 ETHEL AVE
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-2787
Practice Address - Country:US
Practice Address - Phone:415-310-4866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA241091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical