Selena Sandra Plummer, MED

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMH3638 Issued in FL

Practice address

765 SE 53Rd St
Keystone Heights, FL 32656-6356

Phone

(904) 364-6381

NPI assigned

May 30, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225239015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 SE 53RD ST",
            "city": "KEYSTONE HEIGHTS",
            "state": "FL",
            "postal_code": "326566356",
            "telephone_number": "904-364-6381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 SE 53RD ST",
            "city": "KEYSTONE HEIGHTS",
            "state": "FL",
            "postal_code": "326566356",
            "telephone_number": "904-364-6381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLUMMER",
        "first_name": "SELENA",
        "middle_name": "SANDRA",
        "name_prefix": "Mrs.",
        "credential": "MED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH3638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Florida Pharmacy of Keystone Heights Inc
• Magda Luisa Orsini-Ortiz, M.D.
• Park of the Palms, Inc.
• Lawrence Ellis Parrish, DVM
• Physicians Care of Keystone
• Shannon Kate Pollock
• Potter Speech & Language Therapy, LLC
• Marlee Elizabeth Potter
• Claudia T Prino, PSYD
• George L Restea, MD

• Mental Health Counselor in Keystone Heights, FL
• Providers in Keystone Heights, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.