Provider Demographics
NPI:1972922540
Name:WOLFF, LORI DIANE (MA, MHP, LMFT, CMHS)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:DIANE
Last Name:WOLFF
Suffix:
Gender:F
Credentials:MA, MHP, LMFT, CMHS
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:DIANE
Other - Last Name:BOHNSTEHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, MHP, LMFT, CMHS
Mailing Address - Street 1:909 W MAIN ST STE 108
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-2031
Mailing Address - Country:US
Mailing Address - Phone:253-961-6277
Mailing Address - Fax:360-799-9675
Practice Address - Street 1:909 W MAIN ST STE 108
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-2031
Practice Address - Country:US
Practice Address - Phone:253-961-6277
Practice Address - Fax:360-799-9675
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-10
Last Update Date:2020-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60683291106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist