Provider Demographics
NPI:1114243110
Name:PFEIFFER, STACI (EDS, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:STACI
Middle Name:
Last Name:PFEIFFER
Suffix:
Gender:F
Credentials:EDS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HUNTINGTON RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-7205
Mailing Address - Country:US
Mailing Address - Phone:706-850-7041
Mailing Address - Fax:706-850-7042
Practice Address - Street 1:1 HUNTINGTON RD
Practice Address - Street 2:SUITE 103
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-7204
Practice Address - Country:US
Practice Address - Phone:706-850-7041
Practice Address - Fax:706-850-7042
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-15
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC 004675101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor