MEDICARE: ELIZABETH PFAFF LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	009689-01	NY

General Provider Information

NPI Number	:	1558981431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH PFAFF LMHC

Provider Business Mailing Address
First Line	:	775 N MAIN ST
Second Line	:
City	:	SPRING VALLEY
State	:	NY
Zip	:	10977-8968
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	775 N MAIN ST
Second Line	:
City	:	SPRING VALLEY
State	:	NY
Zip	:	10977-8968
Country	:	US
Telephone Number	:	845-708-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2020
Last Update Date	:	04/21/2020

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