Provider Demographics
NPI:1184724148
Name:PFEIFER, JAMES HENRY (LPCC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:HENRY
Last Name:PFEIFER
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4160 24TH AVE S
Mailing Address - Street 2:STE 102
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-9038
Mailing Address - Country:US
Mailing Address - Phone:701-941-0175
Mailing Address - Fax:701-941-3001
Practice Address - Street 1:4160 24TH AVE S
Practice Address - Street 2:STE 102
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-9038
Practice Address - Country:US
Practice Address - Phone:701-941-0175
Practice Address - Fax:701-941-3001
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND51161504151101YM0800X, 101Y00000X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN236GOPFOtherBCBS
ND25497OtherBCBS
MN951483000Medicaid