Provider Demographics
NPI:1356815781
Name:PFISTER, SCOTT (MS)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:PFISTER
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3908 N PENIEL AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-3458
Mailing Address - Country:US
Mailing Address - Phone:405-467-0634
Mailing Address - Fax:
Practice Address - Street 1:3908 N PENIEL AVE STE 200
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:OK
Practice Address - Zip Code:73008-3458
Practice Address - Country:US
Practice Address - Phone:405-467-0634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-18
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11057106H00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist