| Marlene M Wolf, Llc | |
|
121 Towne St Apt 617 Stamford CT 06902-5945 | |
| (203) 856-9852 | |
| Not Available |
| Full Name | Marlene M Wolf, Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 121 Towne St Apt 617, Stamford, Connecticut |
| Authorized Official Name and Position | Marlene M Wolf (OWNER/CLINICIAN) |
| Authorized Official Contact | 2038569852 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marlene M Wolf, Llc 121 Towne St Apt 617 Stamford CT 06902-5945 Ph: (203) 856-9852 | Marlene M Wolf, Llc 121 Towne St Apt 617 Stamford CT 06902-5945 Ph: (203) 856-9852 |
| NPI Number | 1801371208 |
|---|---|
| Provider Enumeration Date | 10/02/2018 |
| Last Update Date | 07/10/2023 |
| Certification Date | 07/10/2023 |
| Medicare PECOS PAC ID | 1153764691 |
|---|---|
| Medicare Enrollment ID | O20240212002310 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801371208 | NPI | - | NPPES |
| 004069985 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Marlene M Wolf |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1861970949 PECOS PAC ID: 7315380862 Enrollment ID: I20240212002875 |
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