Provider Demographics
NPI:1174630990
Name:WOLF, ELAINE K (MC, LPC)
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:K
Last Name:WOLF
Suffix:
Gender:F
Credentials:MC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 WOLFE AVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80905-1929
Mailing Address - Country:US
Mailing Address - Phone:719-660-9690
Mailing Address - Fax:
Practice Address - Street 1:106 WOLFE AVE
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80905-1929
Practice Address - Country:US
Practice Address - Phone:719-660-9690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO001-1201101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health