Provider Demographics
NPI:1992855548
Name:WOLF, CHAIA CARA (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:CHAIA
Middle Name:CARA
Last Name:WOLF
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 JENKS ST
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-1640
Mailing Address - Country:US
Mailing Address - Phone:413-253-4094
Mailing Address - Fax:
Practice Address - Street 1:441 WEST ST
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2997
Practice Address - Country:US
Practice Address - Phone:413-253-4094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1102261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA198779OtherCOMPHYCH
MAP07927OtherBLUE CROSS BLUE SHIELD
MA198779OtherCOMPHYCH