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
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000566 | CT | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Andover, Hebron, Marlborough Youth & Family Services, Inc. | Marriage & Family Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004259447 | Medicaid | CT |
Other names
- Sandra Louise Tilley
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All providers in Hebron, CT · Marriage & Family Therapist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 15, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.