Provider Demographics
NPI:1942784137
Name:WOLFF, ANDREW WATSON (LMFT)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:WATSON
Last Name:WOLFF
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 WATER ST
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246-3313
Mailing Address - Country:US
Mailing Address - Phone:603-499-7504
Mailing Address - Fax:
Practice Address - Street 1:95 WATER ST
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-3313
Practice Address - Country:US
Practice Address - Phone:603-499-7504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-24
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1712106H00000X
RI00195106H00000X
NH241106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1712OtherMASSACHUSETTS BOARD OF ALLIED MENTAL HEALTH PROFESSIONALS