MEDICARE: MS. ELAINE K. WOLF MC, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	001-1201	CO

General Provider Information

NPI Number	:	1174630990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELAINE K. WOLF MC, LPC

Provider Business Mailing Address
First Line	:	106 WOLFE AVE
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80905-1929
Country	:	US
Telephone Number	:	719-660-9690
Fax Number	:

Provider Business Practice Location Address
First Line	:	106 WOLFE AVE
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80905-1929
Country	:	US
Telephone Number	:	719-660-9690
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	01/31/2023

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