Elissa Pfau, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC-7286 Issued in ID

Practice address

8601 W Emerald St Ste 130
Boise, ID 83704-8209

Phone

(208) 600-2184

NPI assigned

Apr 13, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1104406065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1553 E TUTTLE ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836464861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8601 W EMERALD ST STE 130",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048209",
            "telephone_number": "208-600-2184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFAU",
        "first_name": "ELISSA",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "LPC-7286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydnee Paige Petty
• Tyray M Petty
• Jeffrey A Pewe, P.A.
• Pfaff Chiropractic & Rehabilitation PLLC
• Brian Pfaff, CHIROPRACTOR
• Ryan Kurt Pfleger, PA-C
• James Emrys Pfost, DDS
• Paul Phail, D.O.
• Ngan Pham, PHARMD
• Ryan Pham, MD

• Professional Counselor in Boise, ID
• Providers in Boise, ID by specialty
• Professional Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.