Provider Demographics
NPI:1881130722
Name:WOLF, DANIELLE M (LMSW)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:M
Last Name:WOLF
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:M
Other - Last Name:LANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:711 TROY SCHENECTADY RD STE 203
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2461
Mailing Address - Country:US
Mailing Address - Phone:518-782-3700
Mailing Address - Fax:518-782-3799
Practice Address - Street 1:391 MYRTLE AVE STE 4A
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3797
Practice Address - Country:US
Practice Address - Phone:518-207-2273
Practice Address - Fax:518-207-2293
Is Sole Proprietor?:No
Enumeration Date:2017-01-17
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071934104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker