Provider Demographics
NPI:1386304640
Name:THE PLUM PSYCHOLOGY, LLC
Entity type:Organization
Organization Name:THE PLUM PSYCHOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & MANAGER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RONNESIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GASKINS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, MSPH
Authorized Official - Phone:401-267-2753
Mailing Address - Street 1:11 S ANGELL ST # 361
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-5206
Mailing Address - Country:US
Mailing Address - Phone:401-267-2753
Mailing Address - Fax:
Practice Address - Street 1:11 S ANGELL ST # 361
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-5206
Practice Address - Country:US
Practice Address - Phone:401-267-2753
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)