Provider Demographics
NPI:1043435092
Name:CREAGER-PLUMMER, JODI VANESSA (LPCC/LPC)
Entity type:Individual
Prefix:MRS
First Name:JODI
Middle Name:VANESSA
Last Name:CREAGER-PLUMMER
Suffix:
Gender:F
Credentials:LPCC/LPC
Other - Prefix:MISS
Other - First Name:JODI
Other - Middle Name:VANESSA
Other - Last Name:CREAGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC
Mailing Address - Street 1:1601 E LAMAR BLVD
Mailing Address - Street 2:SUITE 214
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-4510
Mailing Address - Country:US
Mailing Address - Phone:575-635-7819
Mailing Address - Fax:
Practice Address - Street 1:1601 E LAMAR BLVD
Practice Address - Street 2:SUITE 214
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-4510
Practice Address - Country:US
Practice Address - Phone:575-635-7819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0123831101YM0800X
TX68021101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health