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General NPI Number Information
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NPI Number | 1811558307
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Entity Type | Individual
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Provider Name | CHARLES WOLFE MA, CAADC
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Gender | Male
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Dates
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Enumeration Date | 06/25/2019
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Last Update Date | 07/23/2019
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Provider Practice Location Address
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Address Line | 1262 WOOD LN STE 102
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City | LANGHORNE
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State | PA
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Zip | 19047-4250
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Country | US
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Telephone | 267-358-5150
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Fax | 267-298-5901
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Provider Business Mailing Address
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Address Line | 1262 WOOD LN STE 102
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City | LANGHORNE
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State | PA
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Zip | 19047-4250
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Country | US
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Telephone | 267-358-5150
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Fax | 267-298-5901
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 13896
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License Number State | PA
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