1407972920 NPI number — MS. CAROL LOUISE WOLF REGISTERED COUNSELOR

Table of content: MS. CAROL LOUISE WOLF REGISTERED COUNSELOR (NPI 1407972920)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407972920 NPI number — MS. CAROL LOUISE WOLF REGISTERED COUNSELOR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WOLF
Provider First Name:
CAROL
Provider Middle Name:
LOUISE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
REGISTERED COUNSELOR
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:
1407972920
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
700 NW GILMAN BLVD STE E103
Provider Second Line Business Mailing Address:
PMB 301
Provider Business Mailing Address City Name:
ISSAQUAH
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98027-8108
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-401-0063
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
700 NW GILMAN BLVD STE E103
Provider Second Line Business Practice Location Address:
PMB 301
Provider Business Practice Location Address City Name:
ISSAQUAH
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98027-8108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-401-0063
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/22/2007

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: 101Y00000X , with the licence number:  RC00032043 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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