Nicole Plummer, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

2508 SE 20TH St
Bentonville, AR 72712-4008

Phone

(479) 845-2111

NPI assigned

Sep 23, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 1, 2026 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Nicole Plummer LLC

  • Clinical Social Worker
  • Bentonville, AR
  • NPI 1215828066
  NPD Authorized official
• PT Concepts, PLLC

  dba Waters Edge Counseling Play Therapy and Training

  • Mental Health Counselor
  • Rogers, AR
  • NPI 1164931291
  NPD
• My Therapy LLC

  • Mental Health Counselor
  • Rogers, AR
  • NPI 1598633091
  NPD (past)
• Psychologyworks, PLLC

  • Psychologist
  • Bentonville, AR
  • NPI 1588256697
  NPD (past)

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

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1407462583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2508 SE 20TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124008",
            "telephone_number": "479-845-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2508 SE 20TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124008",
            "telephone_number": "479-845-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLUMMER",
        "first_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-23",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "10145M",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "296795719",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emma Grace Pitts, PT
• Landon Pitts
• Plastic Surgery Center of Nwa, P.a.
• Leah Beth Platt, LCSW
• Cynthia R Plume, MHPP
• Jessica Pointer, RBT
• Sherry Pointer, MS, LPC, TTS
• Alicia Nichole Polk
• Christian Polovich, CNIM
• Erin Popejoy, PHD, LPC/S

• Clinical Social Worker in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.