Provider Demographics
NPI:1215041017
Name:ALDERFER-MUMMA, CHARIS ESTELLE (ATR-BC, LPC, LMHC)
Entity Type:Individual
Prefix:
First Name:CHARIS
Middle Name:ESTELLE
Last Name:ALDERFER-MUMMA
Suffix:
Gender:F
Credentials:ATR-BC, LPC, LMHC
Other - Prefix:
Other - First Name:CHARIS
Other - Middle Name:ESTELLE
Other - Last Name:ALDERFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:340 NE MAPLE
Mailing Address - Street 2:
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99163
Mailing Address - Country:US
Mailing Address - Phone:509-334-1133
Mailing Address - Fax:509-332-1608
Practice Address - Street 1:340 NE MAPLE
Practice Address - Street 2:
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99163
Practice Address - Country:US
Practice Address - Phone:509-334-1133
Practice Address - Fax:509-332-1608
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004669101YP2500X
WALH60172323101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional