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NPI Code Detail

MEDICARE: KATHRYN WOLFE LICSW

MEDICARE: KATHRYN WOLFE 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
11041C0700XClinical Social Worker089.0090617VT

General Provider Information

NPI Number : 1851636690
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN WOLFE LICSW
Provider Business Mailing Address
First Line : 200 PARK ST
Second Line :
City : MORRISVILLE
State : VT
Zip : 05661-9098
Country : US
Telephone Number : 802-734-5807
Fax Number :
Provider Business Practice Location Address
First Line : 200 PARK ST
Second Line :
City : MORRISVILLE
State : VT
Zip : 05661-9098
Country : US
Telephone Number : 802-441-3380
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2012
Last Update Date : 06/10/2021

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