Provider Demographics
NPI:1548519820
Name:ALLPHIN, PETER A (MSW, LCSWC)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:A
Last Name:ALLPHIN
Suffix:
Gender:M
Credentials:MSW, LCSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 OLYMPIC DR
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25404-0173
Mailing Address - Country:US
Mailing Address - Phone:304-267-7904
Mailing Address - Fax:
Practice Address - Street 1:603 OLYMPIC DR
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25404-0173
Practice Address - Country:US
Practice Address - Phone:304-267-7904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-02
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD088681041C0700X
WVDP009441361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical