Provider Demographics
NPI:1700855129
Name:ALLEN, JOHN A (MSW, LISW, LPCC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:ALLEN
Suffix:
Gender:M
Credentials:MSW, LISW, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5750 CAMBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NEW CONCORD
Mailing Address - State:OH
Mailing Address - Zip Code:43762-9680
Mailing Address - Country:US
Mailing Address - Phone:740-826-4871
Mailing Address - Fax:
Practice Address - Street 1:2845 BELL ST
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1720
Practice Address - Country:US
Practice Address - Phone:740-454-9766
Practice Address - Fax:740-588-6452
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE669101YP2500X
OHI14641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000176697OtherANTHEM PIN
OH112402OtherMOUNT CARMEL PIN
OH1044430OtherCIGNA BH PIN
OH212123OtherTRICARE/MHN PIN
OH6207781OtherUBH PIN
OH7399187OtherAETNA PIN
OHY147362OtherTHE HEALTH PLAN PIN
OH112401OtherMOUNT CARMEL PIN
OH142096OtherCOMPSYCH BH PIN
OH142096OtherCOMPSYCH BH PIN