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General NPI Number Information
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NPI Number | 1215152533
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Entity Type | Individual
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Provider Name | BETH A WOLFE PHD, LMHC
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Gender | Female
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 10/25/2016
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Provider Practice Location Address
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Address Line | 2194 HIGHWAY A1A SUITE 203
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City | INDIAN HARBOUR BEACH
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State | FL
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Zip | 32937-4930
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Country | US
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Telephone | 321-821-0762
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Fax | 321-773-5479
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Provider Business Mailing Address
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Address Line | 2194 HIGHWAY A1A SUITE 203
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City | INDIAN HARBOUR BEACH
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State | FL
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Zip | 32937-4930
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Country | US
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Telephone | 321-821-0762
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 12047
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License Number State | FL
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