Provider Demographics
NPI:1952600538
Name:S/S WOLFE COUNSELING, LLC
Entity Type:Organization
Organization Name:S/S WOLFE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:PROUT
Authorized Official - Last Name:WOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:731-686-9383
Mailing Address - Street 1:5120 TELECOM DR
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:TN
Mailing Address - Zip Code:38358-3495
Mailing Address - Country:US
Mailing Address - Phone:731-686-9383
Mailing Address - Fax:731-686-9384
Practice Address - Street 1:5120 TELECOM DR
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:TN
Practice Address - Zip Code:38358-3495
Practice Address - Country:US
Practice Address - Phone:731-686-9383
Practice Address - Fax:731-686-9384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-22
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000011891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty