Organization
JESSICA J. WOLKE LICSW INC
Active
Other names
Jessica J. Wolke
Organization subpart
No
Provider details
NPI number
Authorized official
TONYA CASSELL (BILLING AGENT)
(860) 405-4951
Entity
Organization
Contact information
Practice address
21 CANAL ST STE 201, WESTERLY, RI 02891-1587
(401) 596-8830
Mailing address
21 CANAL ST STE 201, WESTERLY, RI 02891-1587
(401) 596-2475
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ISW01554
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U300404468
MEDICARE PTAN
RI
Enumeration date
11/22/2017
Last updated
01/01/2024
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