1013040427 NPI number — DR. MICHELE CALLAHAN WOLFSON MENTAL HEALTH COUNSE

Table of content: DR. MICHELE CALLAHAN WOLFSON MENTAL HEALTH COUNSE (NPI 1013040427)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013040427 NPI number — DR. MICHELE CALLAHAN WOLFSON MENTAL HEALTH COUNSE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WOLFSON
Provider First Name:
MICHELE
Provider Middle Name:
CALLAHAN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MENTAL HEALTH COUNSE
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013040427
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/10/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 536
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOUTH WELLFLEET
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02663-0536
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-349-3790
Provider Business Mailing Address Fax Number:
508-349-3790

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
90 LIEUTENANT ISLAND ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH WELLFLEET
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02663-0536
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-221-0549
Provider Business Practice Location Address Fax Number:
508-349-3790
Provider Enumeration Date:
03/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  894 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: LM1145 . This is a "BCBS PROVIDER NUMBER" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com