MEDICARE: MS. GENEVIEVE WOLFF 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	178.015172	IL

General Provider Information

NPI Number	:	1609425222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GENEVIEVE WOLFF LPC

Provider Business Mailing Address
First Line	:	2752 WOODBINE AVE
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-1566
Country	:	US
Telephone Number	:	773-844-6706
Fax Number	:

Provider Business Practice Location Address
First Line	:	6033 N SHERIDAN RD STE S7
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60660-3013
Country	:	US
Telephone Number	:	855-264-9355
Fax Number	:

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

Provider Enumeration Date	:	09/06/2019
Last Update Date	:	09/06/2019

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