Healthcare Provider Details

I. General information

NPI: 1306459805
Provider Name (Legal Business Name): GABRIEL LOGAN PFEIFFER MA, LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2020
Last Update Date: 08/25/2020
Certification Date: 08/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7921 SOUTHPARK PLZ STE 204
LITTLETON CO
80120-4506
US

IV. Provider business mailing address

7921 SOUTHPARK PLZ STE 204
LITTLETON CO
80120-4506
US

V. Phone/Fax

Practice location:
  • Phone: 720-489-8555
  • Fax:
Mailing address:
  • Phone: 720-489-8555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0017605
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: