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General NPI Number Information
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NPI Number | 1851777551
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Entity Type | Individual
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Provider Name | PAMELA ANN WOLFF LCSW, LADAC
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Gender | Female
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Dates
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Enumeration Date | 08/04/2015
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Last Update Date | 05/09/2019
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Provider Practice Location Address
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Address Line | 6324 LOFTUS AVE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-2718
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Country | US
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Telephone | 505-507-1022
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Fax | 505-323-5651
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Provider Business Mailing Address
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Address Line | 6324 LOFTUS AVE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-2718
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Country | US
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Telephone | 505-507-1022
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Fax | 505-323-5651
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C-08546
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0179961
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License Number State | NM
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