Provider Demographics
NPI:1467976597
Name:WOLFE, CHARMAINE ROSEMARIE (LMHC)
Entity type:Individual
Prefix:
First Name:CHARMAINE
Middle Name:ROSEMARIE
Last Name:WOLFE
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:PO BOX 512139
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33951-2139
Mailing Address - Country:US
Mailing Address - Phone:941-625-5895
Mailing Address - Fax:941-625-1047
Practice Address - Street 1:4161 TAMIAMI TRL STE 304D
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-9254
Practice Address - Country:US
Practice Address - Phone:416-255-8959
Practice Address - Fax:941-625-1047
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-31
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH18556101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health