Provider Demographics
NPI:1386010973
Name:WOLF CREEK COUNSELING, LLC
Entity type:Organization
Organization Name:WOLF CREEK COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:BARB
Authorized Official - Middle Name:
Authorized Official - Last Name:FRYE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:330-603-9459
Mailing Address - Street 1:1219 HIGH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-7109
Mailing Address - Country:US
Mailing Address - Phone:330-690-2337
Mailing Address - Fax:
Practice Address - Street 1:1219 HIGH ST STE 100
Practice Address - Street 2:
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281-7109
Practice Address - Country:US
Practice Address - Phone:330-690-2337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC. 1200010101Y00000X, 101YA0400X, 101YM0800X
OHE.0007875101Y00000X, 101YP2500X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty