Individual
MYRA PFEIFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMLP, LCP, LCAC
Contact information
Practice address
210 W 21ST ST, CONCORDIA, KS 66901
(785) 243-8900
(785) 243-8933
Mailing address
PO BOX 747, MANHATTAN, KS 66505-0747
(785) 587-4300
(785) 587-4377
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
203
KS
103T00000X
Psychologist
0470
KS
103T00000X
Psychologist
Primary
903
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11654638
CAQH
—
05
—
200441300A
—
KS
01
—
856674
BCBS
KS
Enumeration date
06/14/2006
Last updated
05/18/2021
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