Provider Demographics
NPI:1679957476
Name:KACMAR, ALLISON (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:
Last Name:KACMAR
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 1:8625 WOODVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22153-1547
Mailing Address - Country:US
Mailing Address - Phone:571-409-6653
Mailing Address - Fax:
Practice Address - Street 1:8001 FORBES PL STE 211
Practice Address - Street 2:
Practice Address - City:NORTH SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22151-2205
Practice Address - Country:US
Practice Address - Phone:571-409-6653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-13
Last Update Date:2024-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2538731041C0700X
NCP0097691041C0700X
DCLC2000020371041C0700X
VA09040129751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical