MEDICARE: MR. CHRISTIAN WOLFE LPCC, LADC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	304941	MN
2	101YM0800X	Mental Health Counselor	2726	MN

General Provider Information

NPI Number	:	1235838376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRISTIAN WOLFE LPCC, LADC

Provider Business Mailing Address
First Line	:	1595 SELBY AVE STE 105
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55104-6285
Country	:	US
Telephone Number	:	651-321-1030
Fax Number	:

Provider Business Practice Location Address
First Line	:	1595 SELBY AVE STE 105
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55104-6285
Country	:	US
Telephone Number	:	651-321-1030
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2023
Last Update Date	:	08/08/2024

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