Provider Demographics
NPI:1881872794
Name:HALPERIN, MARTHA A (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:A
Last Name:HALPERIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3033 WILSON BLVD
Mailing Address - Street 2:#600B
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201
Mailing Address - Country:US
Mailing Address - Phone:703-228-4995
Mailing Address - Fax:703-228-5234
Practice Address - Street 1:1725 N GEORGE MASON DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205
Practice Address - Country:US
Practice Address - Phone:703-228-4995
Practice Address - Fax:703-228-5234
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040039291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA29293001OtherAMERIGROUP
VA29293001OtherAMERIGROUP