Provider Demographics
NPI:1497466288
Name:WOLF, ZACHARY M (LCSW)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:M
Last Name:WOLF
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45-586 KANAKA PL
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-1725
Mailing Address - Country:US
Mailing Address - Phone:808-228-4057
Mailing Address - Fax:
Practice Address - Street 1:45-586 KANAKA PL
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-1725
Practice Address - Country:US
Practice Address - Phone:808-228-4057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-48281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical