Provider Demographics
NPI:1528116381
Name:PLOTNICK, RAYMOND (LCSW)
Entity type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:
Last Name:PLOTNICK
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 WASHINGTON ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CAMDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04843-1739
Mailing Address - Country:US
Mailing Address - Phone:207-236-4300
Mailing Address - Fax:207-236-4340
Practice Address - Street 1:27 WASHINGTON ST
Practice Address - Street 2:SUITE 203
Practice Address - City:CAMDEN
Practice Address - State:ME
Practice Address - Zip Code:04843-1739
Practice Address - Country:US
Practice Address - Phone:207-236-4300
Practice Address - Fax:207-236-4340
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC7131101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME038775OtherANTHEM STAR NUMBER
MEMM9612Medicare ID - Type Unspecified