Provider Demographics
NPI:1235282955
Name:WOLFE, KARON ANNETTE (LISW)
Entity Type:Individual
Prefix:MRS
First Name:KARON
Middle Name:ANNETTE
Last Name:WOLFE
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:MS
Other - First Name:KARON
Other - Middle Name:ANNETTE
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:127 W HARMON DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45331-2335
Mailing Address - Country:US
Mailing Address - Phone:937-547-9118
Mailing Address - Fax:
Practice Address - Street 1:212 E MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331-1913
Practice Address - Country:US
Practice Address - Phone:937-548-1635
Practice Address - Fax:937-548-1500
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS 0027588104100000X
OHI. 08000121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker