MEDICARE: MR. BENJAMIN J WOLF LICSW

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	1041C0700X	Clinical Social Worker	16965	MN

General Provider Information

NPI Number	:	1538370820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BENJAMIN J WOLF LICSW

Provider Business Mailing Address
First Line	:	11105 ZEBULON PIKE AVE
Second Line	:
City	:	BURNSVILLE
State	:	MN
Zip	:	55337-1151
Country	:	US
Telephone Number	:	612-802-9398
Fax Number	:

Provider Business Practice Location Address
First Line	:	13750 CROSSTOWN DR NW
Second Line	:	SUITE L101
City	:	ANDOVER
State	:	MN
Zip	:	55304-5853
Country	:	US
Telephone Number	:	763-482-9598
Fax Number	:

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

Provider Enumeration Date	:	05/25/2007
Last Update Date	:	07/08/2007

Similar Medicare Providers

1023897105 — OLIVIA MCKAY WOLFF-HERDA MA
Practice Location Address:

13750 CROSSTOWN DR NW STE 10
ANDOVER, MN
55304-5853

Practice Phone: 763-317-8255
Practice Fax: 855-913-2522

1255337408 — DR. WAYNE EDWARD PRATT D.C.
Practice Location Address:

13750 CROSSTOWN DR NW , SUITE L102
ANDOVER, MN
55304-5853

Practice Phone: 763-767-1800
Practice Fax: 763-767-1818

1689745549 — AMY MICHELLE JOYCE M.A., L.M.F.T.
Practice Location Address:

13750 CROSSTOWN DR NW , SUITE 102
ANDOVER, MN
55304-5853

Practice Phone: 763-482-9598
Practice Fax:

1013063213 — MRS. MELISSA SUE LONSKY CCC-SLP, OM
Practice Location Address:

13750 CROSSTOWN DR NW
ANDOVER, MN
55304-5853

Practice Phone: 763-755-4275
Practice Fax: 763-755-4261

1770629297 — CARRIE LATVALA JERYLO M.S., CCC-SLP
Practice Location Address:

13750 CROSSTOWN DR NW , SUITE 310
ANDOVER, MN
55304-5853

Practice Phone: 763-755-4275
Practice Fax: 763-755-4261

1487786018 — MS. LYNN M. SWANSON O.T.R.
Practice Location Address:

13750 CROSSTOWN DR NW
ANDOVER, MN
55304-5853

Practice Phone: 763-755-4275
Practice Fax:

Directions to “ MR. BENJAMIN J WOLF LICSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.