Provider Demographics
NPI:1609185552
Name:WOLFE, JEANNE (MA, LPCC)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:
Last Name:WOLFE
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8490 WOODBURY XING
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-9433
Mailing Address - Country:US
Mailing Address - Phone:651-739-1128
Mailing Address - Fax:
Practice Address - Street 1:8490 WOODBURY CROSSING
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-9433
Practice Address - Country:US
Practice Address - Phone:651-739-1128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-27
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN784101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health