Provider Demographics
NPI:1154943223
Name:WOLF, VERONIQUE M (MS, LPC, CSAC)
Entity type:Individual
Prefix:
First Name:VERONIQUE
Middle Name:M
Last Name:WOLF
Suffix:
Gender:F
Credentials:MS, LPC, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10119 BRIGHAM TRL
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:IL
Mailing Address - Zip Code:60034-8935
Mailing Address - Country:US
Mailing Address - Phone:262-812-3440
Mailing Address - Fax:
Practice Address - Street 1:10119 BRIGHAM TRL
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:IL
Practice Address - Zip Code:60034-8935
Practice Address - Country:US
Practice Address - Phone:262-812-3440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-12
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16311-132101YA0400X
WI7837-125101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)