Provider Demographics
NPI:1649625682
Name:PFEIFER, DOUGLAS
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:
Last Name:PFEIFER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 N HILLS DR
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26104-9224
Mailing Address - Country:US
Mailing Address - Phone:304-481-8993
Mailing Address - Fax:
Practice Address - Street 1:100 WOOD DUCK LANE
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:WV
Practice Address - Zip Code:26187
Practice Address - Country:US
Practice Address - Phone:043-758-8003
Practice Address - Fax:304-375-8801
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-27
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0008218101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health