Basic Information
| Provider Information | |||||||||
| NPI: | 1841802758 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALLPERE | ||||||||
| FirstName: | KRISTIN | ||||||||
| MiddleName: | |||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 JEFFERSON ST STE 2C | ||||||||
| Address2: | |||||||||
| City: | LYNCHBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 245041724 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5402176461 | ||||||||
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| Practice Location | |||||||||
| Address1: | 25 WHITLOCK PL SW STE 101 | ||||||||
| Address2: | |||||||||
| City: | MARIETTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300643142 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4044399981 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2020 | ||||||||
| LastUpdateDate: | 08/21/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | CSW003847 | GA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.