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General NPI Number Information
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NPI Number | 1083154504
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Entity Type | Organization
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Legal Business Name | LISA WOLF MS LCSW
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Dates
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Enumeration Date | 03/02/2017
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Last Update Date | 03/02/2017
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Provider Practice Location Address
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Address Line | 680 WESTFIELD AVE
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City | WESTFIELD
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State | NJ
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Zip | 07090-3325
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Country | US
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Telephone | 908-370-9044
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Fax |
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Provider Business Mailing Address
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Address Line | 680 WESTFIELD AVE
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City | WESTFIELD
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State | NJ
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Zip | 07090-3325
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Country | US
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Telephone | 908-370-9044
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | LISA RACHEL WOLF
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Credential | MS LCSW
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Telephone | 908-370-9044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC00871100
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License Number State | NJ
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