Provider Demographics
NPI:1558679092
Name:WOLFE, KATHRYN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:
Last Name:WOLFE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 JEFFERSON BLVD
Mailing Address - Street 2:SUITE 2009
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2234
Mailing Address - Country:US
Mailing Address - Phone:401-527-9179
Mailing Address - Fax:
Practice Address - Street 1:931 JEFFERSON BLVD
Practice Address - Street 2:SUITE 2009
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-2234
Practice Address - Country:US
Practice Address - Phone:401-527-9179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMFT00136106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist