Provider Demographics
NPI:1184176489
Name:WOLFE, LYNLEY ANNE (LMSW)
Entity type:Individual
Prefix:
First Name:LYNLEY
Middle Name:ANNE
Last Name:WOLFE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:LYNLEY
Other - Middle Name:ANNE
Other - Last Name:BURROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:3519 50TH ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310-2649
Mailing Address - Country:US
Mailing Address - Phone:319-830-3755
Mailing Address - Fax:
Practice Address - Street 1:3519 50TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-2649
Practice Address - Country:US
Practice Address - Phone:319-830-3755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-03
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA008180104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker