MEDICARE: PETER SEUFFERT LMFT

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1861094500
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PETER SEUFFERT LMFT

Provider Business Mailing Address
First Line	:	8071 BUCKEYE TREE LN
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80927-4027
Country	:	US
Telephone Number	:	401-439-1652
Fax Number	:

Provider Business Practice Location Address
First Line	:	8071 BUCKEYE TREE LN
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80927-4027
Country	:	US
Telephone Number	:	401-439-1652
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	PETER SEUFFERT
Credential	:
Telephone Number	:	401-439-1652

Provider Enumeration Date	:	11/09/2020
Last Update Date	:	11/09/2020

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