Active NPI
Carol J Pfaffly, PHD
- Marriage & Family Therapist
- Canon City, CO
National Provider Identifier
1629092291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 176
- Practice address
- 3225 Independence Rd
Canon City, CO 81212-9380 - Phone
- (719) 275-2351
- Fax
- (719) 269-9386
- NPI assigned
- Jul 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 176 | CO | Primary |
Addresses
Primary practice location
3225 Independence Rd
Canon City, CO 81212-9380
Mailing address
3225 Independence Rd
Canon City, CO 81212-9380
Phone (719) 275-2351
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07176001 | Medicaid | CO |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 176 | CO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421798400000",
"number": "1629092291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3225 INDEPENDENCE RD",
"city": "CANON CITY",
"state": "CO",
"postal_code": "812129380",
"telephone_number": "719-275-2351",
"fax_number": "719-269-9386"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3225 INDEPENDENCE RD",
"city": "CANON CITY",
"state": "CO",
"postal_code": "812129380",
"telephone_number": "719-275-2351",
"fax_number": "719-269-9386"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PFAFFLY",
"first_name": "CAROL",
"middle_name": "J",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-27",
"last_updated": "2015-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CO",
"license": "176",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "07176001",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Canon City, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.