Marc Plumb, RADT-1

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

R1481240922 Issued in CA

Practice address

484 Pleasant Valley Rd. #4
Diamond Springs, CA 95619-9561

Phone

(530) 344-7633

NPI assigned

May 15, 2023

Sex

Male

Sole proprietor

No

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

State licenses

Practice roles

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.

• Shamanic Living Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Diamond Springs, CA
  • NPI 1407346513
  NPD (past)

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1992496715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 PLEASANT VALLEY RD.",
            "address_2": "SUITE 4",
            "city": "DIAMOND SPRINGS",
            "state": "CA",
            "postal_code": "95619",
            "telephone_number": "530-344-7633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "484 PLEASANT VALLEY RD. #4",
            "city": "DIAMOND SPRINGS",
            "state": "CA",
            "postal_code": "956199561",
            "telephone_number": "530-344-7633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLUMB",
        "first_name": "MARC",
        "credential": "RADT-1",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R1481240922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Suzanne Perkins, LCSW
• Larina Peters
• Aamina Nahanda Phineas, RADT
• Hanna Ilyse Pierson, MA
• Anthony Pinatelli
• Samantha Pollotta
• Teri Prather
• Robert Edward Price, M.D.
• Melissa Lorraine Prophet
• John Bruce Quantrille

• Addiction (Substance Use Disorder) Counselor in Diamond Springs, CA
• Providers in Diamond Springs, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; 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.