Provider Demographics
NPI:1902794753
Name:PELFREY, RICHARD (LMHC, LADAC)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:
Last Name:PELFREY
Suffix:
Gender:M
Credentials:LMHC, LADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 846
Mailing Address - Street 2:
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571-0846
Mailing Address - Country:US
Mailing Address - Phone:931-446-9325
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 846
Practice Address - Street 2:
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-0846
Practice Address - Country:US
Practice Address - Phone:931-446-9325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCTB-2025-0040101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health