Healthcare Provider Details

I. General information

NPI: 1689688962
Provider Name (Legal Business Name): MICHELLE WOLF ACREE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2006
Last Update Date: 08/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9702 GAYTON RD
RICHMOND VA
23238-4907
US

IV. Provider business mailing address

9702 GAYTON RD #181
RICHMOND VA
23238-4907
US

V. Phone/Fax

Practice location:
  • Phone: 804-282-9133
  • Fax: 804-741-7900
Mailing address:
  • Phone: 804-282-9133
  • Fax: 804-741-7900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904001835
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: