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General NPI Number Information
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NPI Number | 1528147360
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Entity Type | Individual
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Provider Name | MICHAEL PAUL WOLFF PSYD
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Gender | Male
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 3292 N EVERGREEN DR NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49525-9746
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Country | US
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Telephone | 616-365-8920
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Fax |
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Provider Business Mailing Address
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Address Line | 300 68TH ST SE APT 2B
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City | GRAND RAPIDS
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State | MI
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Zip | 49548-6927
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Country | US
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Telephone | 616-455-5000
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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 | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number | 6301012443
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number | 6301012443
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6301012443
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number | 6301012443
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 6301012443
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License Number State | MI
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Taxonomy #6
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 6301012443
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License Number State | MI
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