Individual
MICHAEL J WOLFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
110 N WILLOW ST, KENAI, AK 99611-7701
(907) 283-6693
(907) 283-7088
Mailing address
PO BOX 1617, KENAI, AK 99611-1617
(208) 293-5673
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-26944
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000101 53279
REGENCE BLUE SHIELD
ID
01
—
200014396
CORP CARE EAP
ID
01
—
200014396
IDAHO PHYSICIAN NETWORK
—
01
—
2212157
CIGNA BEHAVIORAL HEALTH
ID
01
—
262226
COMP PSYCH
ID
01
—
7266724
AETNA
ID
01
—
L5774
BLUE CROSS OF IDAHO
ID
Enumeration date
08/12/2006
Last updated
01/16/2014
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