Provider Demographics
NPI:1871033100
Name:WOLF, KATE (LPC)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:
Last Name:WOLF
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 1:217 UNION AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-3247
Mailing Address - Country:US
Mailing Address - Phone:814-937-5068
Mailing Address - Fax:
Practice Address - Street 1:217 UNION AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-3247
Practice Address - Country:US
Practice Address - Phone:814-937-5068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-06
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003006101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional