Provider Demographics
NPI:1548201130
Name:ALLMAN, MARTHA JEAN (LPC)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:JEAN
Last Name:ALLMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1223 3RD ST SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-4611
Mailing Address - Country:US
Mailing Address - Phone:540-342-3848
Mailing Address - Fax:540-342-2148
Practice Address - Street 1:1223 3RD ST SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-4611
Practice Address - Country:US
Practice Address - Phone:540-342-3848
Practice Address - Fax:540-342-2148
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
VA0717000409106H00000X
VA0701002021101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1548201130Medicaid
VA264684000OtherMAGELLAN
VA54115900103OtherUBH
VAO80941MOtherSENTARA
VA1627923OtherUNITED HEALTHCARE
VA343700OtherMAMSI
VA005400571Medicaid
VA0206255OtherVALUE OPTIONS
VA240064OtherANTHEM BCBS