Provider Demographics
NPI:1164674446
Name:WOLF, ERIK DANIEL (MA, LMHC)
Entity Type:Individual
Prefix:MR
First Name:ERIK
Middle Name:DANIEL
Last Name:WOLF
Suffix:
Gender:M
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 DISCOVERY DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-3709
Mailing Address - Country:US
Mailing Address - Phone:407-281-7000
Mailing Address - Fax:407-282-7012
Practice Address - Street 1:2500 DISCOVERY DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32826-3709
Practice Address - Country:US
Practice Address - Phone:407-281-7000
Practice Address - Fax:407-282-7012
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-17
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 7874101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health