Provider Demographics
NPI:1679954580
Name:WOLFE, ABIGAIL SUSAN (LMSW)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:SUSAN
Last Name:WOLFE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:HAGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:3407 GRAND AVE APT 215
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50312-4136
Mailing Address - Country:US
Mailing Address - Phone:810-358-3461
Mailing Address - Fax:
Practice Address - Street 1:1801 HICKMAN RD
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-1505
Practice Address - Country:US
Practice Address - Phone:616-248-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-16
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker