Provider Demographics
NPI:1831105402
Name:WOLFF-KNUFFKE, LILY (LPC)
Entity Type:Individual
Prefix:
First Name:LILY
Middle Name:
Last Name:WOLFF-KNUFFKE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4851 INDEPENDENCE STREET
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-6715
Mailing Address - Country:US
Mailing Address - Phone:303-425-0300
Mailing Address - Fax:303-432-5036
Practice Address - Street 1:9485 WEST COLFAX AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215
Practice Address - Country:US
Practice Address - Phone:303-432-5200
Practice Address - Fax:303-432-5260
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18175101YP2500X
CO6505101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1562217-02Medicaid
TX156221703Medicaid
TX83800LOtherALPHA OMEGA BCBS