Provider Demographics
NPI:1275297590
Name:WOLFE, MEGAN (LSW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:WOLFE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 739
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17023-0739
Mailing Address - Country:US
Mailing Address - Phone:717-362-8900
Mailing Address - Fax:717-362-8910
Practice Address - Street 1:20 CLEARFIELD ST
Practice Address - Street 2:
Practice Address - City:ELIZABETHVILLE
Practice Address - State:PA
Practice Address - Zip Code:17023
Practice Address - Country:US
Practice Address - Phone:717-362-8900
Practice Address - Fax:717-362-8901
Is Sole Proprietor?:No
Enumeration Date:2021-10-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1386791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical