Individual provider Active NPI

Judith L. Wolfe, LPC

  • Professional Counselor
  • Martinez, GA
National Provider Identifier
1053494690
Registry record updated Jul 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
004741 Issued in GA
Practice address
211 Pleasant Home Rd
Suite B-2
Martinez, GA 30907-0518
Phone
(706) 513-1313
Fax
(706) 854-0432
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 004741 GA Primary

Addresses

Primary practice location

211 Pleasant Home Rd
Suite B-2
Martinez, GA 30907-0518

Mailing address

1318 Wingfield St
Augusta, GA 30904-4757
Phone (706) 513-1313

Other identifiers 1

IdentifierTypeStateIssuer
000606317BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
004741GAMDProfessional Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279670400000",
    "number": "1053494690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 WINGFIELD ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309044757",
            "telephone_number": "706-513-1313",
            "fax_number": "706-733-1098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 PLEASANT HOME RD",
            "address_2": "SUITE B-2",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309070518",
            "telephone_number": "706-513-1313",
            "fax_number": "706-854-0432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFE",
        "first_name": "JUDITH",
        "middle_name": "L.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2010-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "004741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000606317B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinez, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.