Provider Demographics
NPI:1639423890
Name:LILIAN PFEIFFER LCSW P.A.
Entity type:Organization
Organization Name:LILIAN PFEIFFER LCSW P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LILIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PFEIFFER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:954-801-5312
Mailing Address - Street 1:1950 NW 107TH AVE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-2318
Mailing Address - Country:US
Mailing Address - Phone:954-801-5312
Mailing Address - Fax:954-212-0477
Practice Address - Street 1:600 N HIATUS RD
Practice Address - Street 2:SUITE 201
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-5207
Practice Address - Country:US
Practice Address - Phone:954-801-5312
Practice Address - Fax:954-212-0477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-08
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 4823261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE0496AOtherMEDICARE PTAN