Individual
RUSSEL WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
929 MASSACHUSETTS AVE., ST. 103, CAMBRIDGE, MA 02139
(617) 774-6036
Mailing address
1000 JEFFERSON ST., STE. 2C, LYNCHBURG, VA 24504
(617) 379-0496
(617) 807-0958
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1497
MA
101YP2500X
Professional Counselor
Primary
MH-1497-CC
MA
Other
Enumeration date
11/07/2006
Last updated
03/03/2015
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