Provider Demographics
NPI:1720160138
Name:WOLFE, ALLISON ELIZABETH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:ELIZABETH
Last Name:WOLFE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:ALLISON
Other - Middle Name:ELIZABETH
Other - Last Name:MARCUS-FENNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PSC 3 BOX 2296
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09021-0023
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:UNIT 33100 BOX LANDSTUHL
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09180-3100
Practice Address - Country:US
Practice Address - Phone:515-120-7816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904006378101YM0800X
NCC0065121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0904006378OtherLCSW NUMBER
NCC006512OtherLCSW
VA010326427Medicaid