Provider Demographics
NPI:1932853405
Name:PLUNKETT, ALYSSA (LMSW)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:PLUNKETT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 399
Mailing Address - Street 2:
Mailing Address - City:BAXTER
Mailing Address - State:IA
Mailing Address - Zip Code:50028-0399
Mailing Address - Country:US
Mailing Address - Phone:319-784-8221
Mailing Address - Fax:
Practice Address - Street 1:617 FRANKLIN ST STE 201
Practice Address - Street 2:
Practice Address - City:PELLA
Practice Address - State:IA
Practice Address - Zip Code:50219-1685
Practice Address - Country:US
Practice Address - Phone:319-784-8221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0773541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical