Provider Demographics
NPI:1841816857
Name:WOLFE, KIRSTEN (MS, LPC)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:
Last Name:WOLFE
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 OLD TOPTON RD
Mailing Address - Street 2:
Mailing Address - City:MERTZTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19539-8733
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2045 WESTGATE DR STE 304
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7475
Practice Address - Country:US
Practice Address - Phone:610-865-8177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-25
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011323101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health