Provider Demographics
NPI:1689148793
Name:PFEIFFER, KATHERINE L (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:L
Last Name:PFEIFFER
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2808 N JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-1510
Mailing Address - Country:US
Mailing Address - Phone:716-208-5733
Mailing Address - Fax:
Practice Address - Street 1:3202 HENDERSON BLVD STE 100A
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-3043
Practice Address - Country:US
Practice Address - Phone:813-603-6827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-11
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15136101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health