Individual provider Active NPI

Elizabeth Cathleen Wolf, LCSW

  • Clinical Social Worker
  • Centennial, CO
National Provider Identifier
1104420694
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
09931051 Issued in CO
Practice address
12150 E Briarwood Ave Unit 202
Centennial, CO 80112-6755
Phone
(720) 662-7862
NPI assigned
Nov 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X 09931051 CO Primary

Addresses

Primary practice location

12150 E Briarwood Ave Unit 202
Centennial, CO 80112-6755

Mailing address

12150 E Briarwood Ave Unit 202
Centennial, CO 80112-6755
Phone (720) 662-7862

Other identifiers 1

IdentifierTypeStateIssuer
479409807OtherPASSPORT

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
09931051COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Childwise Trauma Recovery LLC Clinical Current Accepting new patients

Organizations & group practices 1

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": "1606176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1104420694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12150 E BRIARWOOD AVE UNIT 202",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801126755",
            "telephone_number": "720-662-7862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12150 E BRIARWOOD AVE UNIT 202",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801126755",
            "telephone_number": "720-662-7862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "ELIZABETH",
        "middle_name": "CATHLEEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-24",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "09931051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "479409807",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; 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.