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NPI Code Detail

MEDICARE: DEBORAH WOLFF MSW, LCSW

MEDICARE:   DEBORAH  WOLFF  MSW, LCSW
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
11041C0700XClinical Social Worker44SC05292500NJ
21041C0700XClinical Social Worker0904010847VA

General Provider Information

NPI Number : 1124419171
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH WOLFF MSW, LCSW
Provider Business Mailing Address
First Line : 3712 GLEAMING DR
Second Line :
City : NORTH CHESTERFIELD
State : VA
Zip : 23237-1960
Country : US
Telephone Number : 856-323-4673
Fax Number :
Provider Business Practice Location Address
First Line : 100 CONCOURSE BLVD STE 111
Second Line :
City : GLEN ALLEN
State : VA
Zip : 23059-5642
Country : US
Telephone Number : 856-323-4673
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2015
Last Update Date : 11/28/2023

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