| Doctor Name: | MR. STEPHEN WILLIAM PLUMB |
| NPI Number: | 1194708362 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LISW, LICSW, BCD |
| License Number: | I0009091 |
| Business Practice Address: | 11050 Mt Belvedere Blvd Usa Meddac/credentials Fort Drum, NY - 136025004 |
| Business Phone Number: | 3157724025 |
| Business Fax Number: | 3157729498 |
| Mailing Address: | 360 Brainard St, WATERTOWN |
| State: | NY |
| Postal Code: | 136014004 |
| Phone Number: | 3157853600 |
| Fax Number: | 3157853600 |
| NPI Enumeration Date: | 11/22/2005 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | I0009091 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |