Provider Demographics
NPI:1194965574
Name:ALEGRIA, CHARMAYNE MARIE (LPC)
Entity type:Individual
Prefix:MS
First Name:CHARMAYNE
Middle Name:MARIE
Last Name:ALEGRIA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CHARLY
Other - Middle Name:
Other - Last Name:ALEGRIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:1854 W PUZZLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-3630
Mailing Address - Country:US
Mailing Address - Phone:208-283-5855
Mailing Address - Fax:208-939-9009
Practice Address - Street 1:4822 N ROSEPOINT WAY
Practice Address - Street 2:STE. A
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83713-0944
Practice Address - Country:US
Practice Address - Phone:208-283-5855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-25
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-2938101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional