MEDICARE: ELANA WOOLF THERAPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1043144751
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELANA WOOLF THERAPY

Provider Business Mailing Address
First Line	:	550 RESERVE ST STE 190
Second Line	:
City	:	SOUTHLAKE
State	:	TX
Zip	:	76092-1546
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	550 RESERVE ST STE 190
Second Line	:
City	:	SOUTHLAKE
State	:	TX
Zip	:	76092-1546
Country	:	US
Telephone Number	:	240-630-0393
Fax Number	:

Authorized Official
Title or Position	:	OWNER, THERAPIST
Name	:	MISS ELANA WOOLF
Credential	:	LCPC
Telephone Number	:	301-538-4882

Provider Enumeration Date	:	06/09/2026
Last Update Date	:	06/09/2026

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