Healthcare Provider Details

I. General information

NPI: 1528034857
Provider Name (Legal Business Name): JEFFREY CAMERON ALLMAN LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 03/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 ELECTRIC RD SUITE 100
ROANOKE VA
24018
US

IV. Provider business mailing address

2727 ELECTRIC RD, STE 100 PSYCHOLOGICAL HEALTH ROANOKE
ROANOKE VA
24018
US

V. Phone/Fax

Practice location:
  • Phone: 540-772-5153
  • Fax: 540-772-5157
Mailing address:
  • Phone: 540-772-5153
  • Fax: 540-772-5157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904001148
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904-001148
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: