Provider Demographics
NPI: | 1063437416 |
---|---|
Name: | PFEIFER, LASHAI (MED, LPCC, LMAC) |
Entity type: | Individual |
Prefix: | |
First Name: | LASHAI |
Middle Name: | |
Last Name: | PFEIFER |
Suffix: | |
Gender: | F |
Credentials: | MED, LPCC, LMAC |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 2101 ELM ST N |
Mailing Address - Street 2: | |
Mailing Address - City: | FARGO |
Mailing Address - State: | ND |
Mailing Address - Zip Code: | 58102-2417 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 2101 ELM ST N |
Practice Address - Street 2: | |
Practice Address - City: | FARGO |
Practice Address - State: | ND |
Practice Address - Zip Code: | 58102-2417 |
Practice Address - Country: | US |
Practice Address - Phone: | 701-239-3700 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2006-07-13 |
Last Update Date: | 2024-09-30 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
ND | 1530 | 101YA0400X |
ND | 1243-9-15-22A | 101YM0800X |
ND | 1243-9-15-22-602 | 101YP2500X |
MN | CC02114 | 101YP2500X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional |
No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health |