Provider Demographics
NPI:1942646047
Name:WOLF, DAWN C (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:C
Last Name:WOLF
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1386 RIVER MIST CT
Mailing Address - Street 2:
Mailing Address - City:STONEY BEACH
Mailing Address - State:MD
Mailing Address - Zip Code:21226-2138
Mailing Address - Country:US
Mailing Address - Phone:410-279-3302
Mailing Address - Fax:
Practice Address - Street 1:1386 RIVER MIST CT
Practice Address - Street 2:
Practice Address - City:STONEY BEACH
Practice Address - State:MD
Practice Address - Zip Code:21226-2138
Practice Address - Country:US
Practice Address - Phone:410-279-3302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-15
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD100591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical