Individual provider Active NPI

Justin Wolf

  • Clinical Social Worker
  • Houston, TX
National Provider Identifier
1053797845
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
58264 Issued in TX
Practice address
7000 Fannin St Ste 1620
Houston, TX 77030-5400
Phone
(713) 486-2700
NPI assigned
Aug 4, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 58264 TX
Clinical Social Worker 1041C0700X 58264 TX Primary

Addresses

Primary practice location

7000 Fannin St Ste 1620
Houston, TX 77030-5400

Mailing address

3000 Greenridge Dr
2026
Houston, TX 77057-6056
Phone (713) 391-0539

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240828000902 TX Practitioner - Clinical Social Worker 1052850591 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ut PhysiciansGroup PAC ID 8426960360, 1,744 clinicians

Practice addresses (Care Compare)

7000 Fannin St
Suite 1620
Houston, TX 77030-5400
Phone (713) 500-3267

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Jun 28, 2024 Accepting new patients
Ut Physicians CurrentSince Jun 28, 2024 Accepting new patients

Locations

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

7000 Fannin St
Ste 1620
Houston, TX 77030
Phone (713) 486-2621

6410 Fannin St
#135
Houston, TX 77030

7000 Fannin St
#1620
Houston, TX 77030
Phone (713) 486-2621

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1438646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1053797845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 GREENRIDGE DR",
            "address_2": "2026",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770576056",
            "telephone_number": "713-391-0539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 FANNIN ST STE 1620",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770305400",
            "telephone_number": "713-486-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "JUSTIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-04",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "58264",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "58264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.