Provider Demographics
NPI:1750964458
Name:STACI PFEIFFER-COOK LPC, LLC
Entity type:Organization
Organization Name:STACI PFEIFFER-COOK LPC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDING CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STACI
Authorized Official - Middle Name:
Authorized Official - Last Name:PFEIFFER
Authorized Official - Suffix:
Authorized Official - Credentials:EDS, LPC, CPCS, MAC
Authorized Official - Phone:706-850-7041
Mailing Address - Street 1:1 HUNTINGTON RD STE 103
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-7205
Mailing Address - Country:US
Mailing Address - Phone:706-850-7041
Mailing Address - Fax:706-850-7042
Practice Address - Street 1:1 HUNTINGTON RD STE 103
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-7205
Practice Address - Country:US
Practice Address - Phone:706-850-7041
Practice Address - Fax:706-850-7042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty