Provider Demographics
NPI:1477126431
Name:WOLFF, PETER A (LCPC)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:A
Last Name:WOLFF
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 RECORD ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-5418
Mailing Address - Country:US
Mailing Address - Phone:301-620-8700
Mailing Address - Fax:301-620-8710
Practice Address - Street 1:116 RECORD ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-5418
Practice Address - Country:US
Practice Address - Phone:301-620-8700
Practice Address - Fax:301-620-8710
Is Sole Proprietor?:No
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC11641101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional