Provider Demographics
NPI:1780610170
Name:PLUCINSKI, PAMELA J (PMHNP)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:J
Last Name:PLUCINSKI
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:
Other - Last Name:MCCORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1075 SMITH ST STE 2
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-2700
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1598 S COUNTY TRL STE 102
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-1762
Practice Address - Country:US
Practice Address - Phone:401-369-9224
Practice Address - Fax:401-369-9275
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN04750363LP0808X
MDR236222363LP0808X
RIPPNS00068364SP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI62-93905OtherUNITED BEHAVIORAL HEALTH
RI27113-6OtherBLUE CROSS
RI410992OtherBLUE CHIP
RIPP51113Medicaid