Provider Demographics
NPI:1750944922
Name:PLYMALE, MARK DANIEL
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:DANIEL
Last Name:PLYMALE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353-1349
Mailing Address - Country:US
Mailing Address - Phone:859-498-5230
Mailing Address - Fax:859-498-8973
Practice Address - Street 1:445 E COLLEGE AVE APT 1003
Practice Address - Street 2:
Practice Address - City:STANTON
Practice Address - State:KY
Practice Address - Zip Code:40380-2381
Practice Address - Country:US
Practice Address - Phone:606-481-6043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-15
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA9535101YA0400X
KY175012101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)