Provider Demographics
NPI:1578684171
Name:PHIFER, EDWARD L (MSW, LGSW)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:L
Last Name:PHIFER
Suffix:
Gender:M
Credentials:MSW, LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3017 BEETHOVEN WAY
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-6861
Mailing Address - Country:US
Mailing Address - Phone:301-890-0985
Mailing Address - Fax:
Practice Address - Street 1:3017 BEETHOVEN WAY
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-6861
Practice Address - Country:US
Practice Address - Phone:301-890-0985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC1013101YA0400X
MDG12440104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker