Provider Demographics
NPI:1821134420
Name:ALDERFER, MARY ANNE (LPC, LMFT, EDS)
Entity Type:Individual
Prefix:
First Name:MARY ANNE
Middle Name:
Last Name:ALDERFER
Suffix:
Gender:F
Credentials:LPC, LMFT, EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 N BRADDOCK ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-3900
Mailing Address - Country:US
Mailing Address - Phone:540-662-4365
Mailing Address - Fax:703-852-7175
Practice Address - Street 1:132 N BRADDOCK ST
Practice Address - Street 2:SUITE 2
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3900
Practice Address - Country:US
Practice Address - Phone:540-662-4365
Practice Address - Fax:703-852-7175
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001748101YP2500X
VA0717000653106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA174048OtherCOMPSYCH EAP
VA72710OtherCHS ANDSENTARA PROVIDER #
VA452215OtherANTHEM PROVIDER #