Provider Demographics
NPI:1336758119
Name:PLUMMER, BROOKE ELISE (PLMHP, PCMSW)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:ELISE
Last Name:PLUMMER
Suffix:
Gender:F
Credentials:PLMHP, PCMSW
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:ELISE
Other - Last Name:FLETCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PLMHP, PMCSW
Mailing Address - Street 1:4600 VALLEY RD STE 350
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-4844
Mailing Address - Country:US
Mailing Address - Phone:402-474-0011
Mailing Address - Fax:402-474-0012
Practice Address - Street 1:4600 VALLEY RD STE 350
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-4844
Practice Address - Country:US
Practice Address - Phone:402-474-0011
Practice Address - Fax:402-474-0012
Is Sole Proprietor?:No
Enumeration Date:2020-07-28
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7398104100000X
NE11976101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker