Provider Demographics
NPI:1124008685
Name:WOLFE, MERYA V (MA, LCSW)
Entity Type:Individual
Prefix:MS
First Name:MERYA
Middle Name:V
Last Name:WOLFE
Suffix:
Gender:F
Credentials:MA, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 CORONADO WAY
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-4021
Mailing Address - Country:US
Mailing Address - Phone:919-931-7453
Mailing Address - Fax:
Practice Address - Street 1:223 HIGHWAY 70 E
Practice Address - Street 2:SUITE 130
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529
Practice Address - Country:US
Practice Address - Phone:919-931-7453
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0010741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical