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General NPI Number Information
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NPI Number | 1053178038
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Entity Type | Organization
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Legal Business Name | WOLF COUNSELING & CLINICAL SERVICES, PLLC
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Dates
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Enumeration Date | 03/05/2024
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Last Update Date | 03/05/2024
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Provider Practice Location Address
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Address Line | 20605 N MAIN ST
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City | CORNELIUS
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State | NC
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Zip | 28031-8454
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Country | US
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Telephone | 980-788-9800
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Fax | 980-788-9900
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Provider Business Mailing Address
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Address Line | 9735 AEGEAN CT
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-5919
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Country | US
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Telephone | 704-930-8559
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Fax | 980-788-9900
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Authorized Official
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Title or Position | OWNER
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Name | REBECCA WOLF
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Credential | LCMHCA
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Telephone | 704-930-8559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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