Provider Demographics
NPI:1528034857
Name:ALLMAN, JEFFREY CAMERON (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:CAMERON
Last Name:ALLMAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 ELECTRIC RD, STE 100
Mailing Address - Street 2:PSYCHOLOGICAL HEALTH ROANOKE
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018
Mailing Address - Country:US
Mailing Address - Phone:540-772-5153
Mailing Address - Fax:540-772-5157
Practice Address - Street 1:2727 ELECTRIC RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018
Practice Address - Country:US
Practice Address - Phone:540-772-5153
Practice Address - Fax:540-772-5157
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040011481041C0700X
1041C0700X
VA0904-0011481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010196027Medicaid
VAS49789Medicare UPIN
VA00W533C04Medicare Oscar/Certification
VA010196027Medicaid