Provider Demographics
NPI:1659100642
Name:PLOTT, PAMELA J (LMSW)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:J
Last Name:PLOTT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3022 TRENTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-5938
Mailing Address - Country:US
Mailing Address - Phone:228-278-9468
Mailing Address - Fax:
Practice Address - Street 1:3022 TRENTWOOD DR
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-5938
Practice Address - Country:US
Practice Address - Phone:228-278-9468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-29
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSM-11089104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker