Provider Demographics
NPI:1962164905
Name:ALAGNA-COLE, TERRA ELLEN (LCSW)
Entity type:Individual
Prefix:
First Name:TERRA
Middle Name:ELLEN
Last Name:ALAGNA-COLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:TERRA
Other - Middle Name:ELLEN
Other - Last Name:ALAGNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:301 ELM AVE SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-4001
Mailing Address - Country:US
Mailing Address - Phone:540-345-9841
Mailing Address - Fax:
Practice Address - Street 1:1342 CRAIG ROBERTSON RD SE
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014-3600
Practice Address - Country:US
Practice Address - Phone:540-929-1497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-07
Last Update Date:2024-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040132981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1437137734Medicaid