Provider Demographics
NPI:1285366047
Name:PFEFFER, ELIZABETH A
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:PFEFFER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 RICHMOND DR SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-2353
Mailing Address - Country:US
Mailing Address - Phone:505-980-6517
Mailing Address - Fax:
Practice Address - Street 1:2440 LOUISIANA BLVD NE STE 300
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-4394
Practice Address - Country:US
Practice Address - Phone:505-302-1660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCTB-2022-0175101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health