Sandra Louise Plummer, L.M.F.T.

Individual provider Active NPI Marriage & Family Therapist · Hebron, CT

NPI 1376792234 · NPPES record last updated Mar 15, 2016

Key facts

NPI
1376792234
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
000566 (CT)
Practice address
25 Pendleton Drive
Hebron, CT 06248-1525
Phone
(860) 228-9488
Fax
(860) 228-1213
NPI assigned
Sep 16, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
000566CTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Andover, Hebron, Marlborough Youth & Family Services, Inc. Marriage & Family Therapist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 000566 CT Yes

Addresses

Primary practice location

25 Pendleton Drive
Hebron, CT 06248-1525

Mailing address

25 Pendleton Drive
Hebron, CT 06248-1525
Phone (860) 228-9488

Other identifiers

IdentifierTypeStateIssuer
004259447MedicaidCT

Other names

  • Sandra Louise Tilley Former name

Other providers in Hebron, CT

All providers in Hebron, CT · Marriage & Family Therapist in Connecticut

Sources for this page

Verify at the official NPI Registry.