Provider Demographics
NPI:1154726412
Name:WOLK, COURTNEY LYNN BENJAMIN (PHD)
Entity type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:LYNN BENJAMIN
Last Name:WOLK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:COURTNEY
Other - Middle Name:LYNN
Other - Last Name:BENJAMIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1845 WALNUT ST
Mailing Address - Street 2:15TH FLOOR, ANXIETY & OCD TREATMENT CENTER
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-4708
Mailing Address - Country:US
Mailing Address - Phone:267-737-8088
Mailing Address - Fax:
Practice Address - Street 1:1845 WALNUT ST
Practice Address - Street 2:15TH FLOOR, ANXIETY & OCD TREATMENT CENTER
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-4708
Practice Address - Country:US
Practice Address - Phone:267-737-8088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017590103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent