Individual provider Active NPI

Vincent Harold Plummer, MA, LPCC, NCC

  • Professional Counselor
  • Wahpeton, ND
National Provider Identifier
1679649867
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
201-9-1-91-13 Issued in ND
Practice address
123 2ND Ave N
Wahpeton, ND 58075-4705
Phone
(701) 642-1432
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 201-9-1-91-13 ND
Mental Health Counselor 101YM0800X 201-9-1-91-13 ND
Marriage & Family Therapist 106H00000X 2692 ID
Professional Counselor 101YP2500X 201-9-1-91-13 ND Primary

Addresses

Primary practice location

123 2ND Ave N
Wahpeton, ND 58075-4705

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074

Other identifiers 1

IdentifierTypeStateIssuer
1679649867MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240103004472 ND Practitioner - Mental Health Counselor 6709237720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical Center FargoGroup PAC ID 8426967803, 1,210 clinicians

Practice addresses (Care Compare)

1220 Sheyenne St
West Fargo, ND 58078-2637
Phone (701) 234-4445

420 S 7TH St
Oakes, ND 58474-2024
Phone (701) 742-3267

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2692IDMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Fargo CurrentSince Jan 1, 2024 Accepting new patients
Sanford Medical Center Fargo CurrentSince Jan 1, 2024 Accepting new patients
Sanford Medical Center Fargo Current Accepting new patients

Locations

2400 32nd Ave S
Fargo, ND 58103
Phone (701) 234-8800

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1679649867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 2ND AVE N",
            "city": "WAHPETON",
            "state": "ND",
            "postal_code": "580754705",
            "telephone_number": "701-642-1432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLUMMER",
        "first_name": "VINCENT",
        "middle_name": "HAROLD",
        "name_prefix": "Mr.",
        "credential": "MA, LPCC, NCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2022-08-02",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "ND",
            "license": "201-9-1-91-13",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ND",
            "license": "201-9-1-91-13",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "ID",
            "license": "2692",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ND",
            "license": "201-9-1-91-13",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679649867",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wahpeton, ND

Sources for this page

Verify at the official NPI Registry.