Individual provider Active NPI

Konnor Pfeiffer, LCMHCA

  • Mental Health Counselor
  • Wilmington, NC
National Provider Identifier
1598578304
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A21007 Issued in NC
Practice address
5040 New Centre Dr Ste D
Wilmington, NC 28403-1737
Phone
(571) 970-7073
NPI assigned
Jan 28, 2025
Last updated
Sep 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X A21007 NC Primary

Addresses

Primary practice location

5040 New Centre Dr Ste D
Wilmington, NC 28403-1737

Mailing address

3603 Webster Way Apt 1607
Wilmington, NC 28412-3825
Phone (571) 970-7073

Other identifiers 1

IdentifierTypeStateIssuer
101YP2500XMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A21007NCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1738022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1598578304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3603 WEBSTER WAY APT 1607",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284123825",
            "telephone_number": "571-970-7073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5040 NEW CENTRE DR STE D",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284031737",
            "telephone_number": "571-970-7073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFEIFFER",
        "first_name": "KONNOR",
        "credential": "LCMHCA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-28",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A21007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101YP2500X",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; 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.