Provider Demographics
NPI:1467785998
Name:WOLFF, CHERYL B (LCSW)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:B
Last Name:WOLFF
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 PAVONIA AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-1503
Mailing Address - Country:US
Mailing Address - Phone:718-757-4238
Mailing Address - Fax:
Practice Address - Street 1:1090 AMSTERDAM AVE STE 6A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1737
Practice Address - Country:US
Practice Address - Phone:212-523-2688
Practice Address - Fax:212-523-3206
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-16
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY077561-11041C0700X
NY071005-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health