Provider Demographics
NPI:1821277336
Name:WOLFE, HOLLY JEAN (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:JEAN
Last Name:WOLFE
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6281 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:EVART
Mailing Address - State:MI
Mailing Address - Zip Code:49631-8106
Mailing Address - Country:US
Mailing Address - Phone:231-734-5955
Mailing Address - Fax:231-734-2107
Practice Address - Street 1:6281 RIVER RD
Practice Address - Street 2:
Practice Address - City:EVART
Practice Address - State:MI
Practice Address - Zip Code:49631-8106
Practice Address - Country:US
Practice Address - Phone:231-734-5955
Practice Address - Fax:231-734-2107
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401008772101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional