Provider Demographics
NPI:1174859854
Name:PFEIFER, MARY JO (LMHC)
Entity Type:Individual
Prefix:MS
First Name:MARY JO
Middle Name:
Last Name:PFEIFER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1229 MOUNT LORETTA AVE
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52003-7826
Mailing Address - Country:US
Mailing Address - Phone:563-588-0558
Mailing Address - Fax:583-557-3140
Practice Address - Street 1:2210 LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50014-7106
Practice Address - Country:US
Practice Address - Phone:515-296-2759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-30
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor