Provider Demographics
NPI:1073867131
Name:WOLF, KAREN LYNN (MS, LPCC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:LYNN
Last Name:WOLF
Suffix:
Gender:F
Credentials:MS, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 10TH ST SW
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:MN
Mailing Address - Zip Code:55912-2806
Mailing Address - Country:US
Mailing Address - Phone:507-589-0366
Mailing Address - Fax:
Practice Address - Street 1:1111 28TH ST NE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:MN
Practice Address - Zip Code:55912-6410
Practice Address - Country:US
Practice Address - Phone:507-589-0366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-28
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC00368101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional