Provider Demographics
NPI:1316654783
Name:WOLFF, LAUREL (LMHC)
Entity type:Individual
Prefix:
First Name:LAUREL
Middle Name:
Last Name:WOLFF
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12224 HUNTER RD SW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:WA
Mailing Address - Zip Code:98579-9622
Mailing Address - Country:US
Mailing Address - Phone:360-515-6295
Mailing Address - Fax:
Practice Address - Street 1:12224 HUNTER RD SW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:WA
Practice Address - Zip Code:98579-9622
Practice Address - Country:US
Practice Address - Phone:360-515-6295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61324127101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty