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NPI Code Detail

MEDICARE: MICHAEL WOLFARTH CDCA

MEDICARE: MICHAEL WOLFARTH CDCA
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
1171M00000XCase Manager/Care Coordinator
2101YA0400XAddiction (Substance Use Disorder) CounselorCDCA.169381OH

General Provider Information

NPI Number : 1760963110
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL WOLFARTH CDCA
Provider Business Mailing Address
First Line : 204 2ND ST NE
Second Line :
City : NEW PHILADELPHIA
State : OH
Zip : 44663-2808
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 204 2ND ST NE
Second Line :
City : NEW PHILADELPHIA
State : OH
Zip : 44663-2808
Country : US
Telephone Number : 234-801-2481
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2018
Last Update Date : 07/01/2019

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Directions to “ MICHAEL WOLFARTH CDCA” Practice Location

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