Kelly Suzanne Wolf Craig, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

10605 Issued in MA

Practice address

100 Century Dr
Worcester, MA 01606-1244

Phone

(508) 762-5400

Fax

(508) 762-5410

NPI assigned

May 30, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kelly Suzanne Wolf Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1496102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545091200000",
    "number": "1114455516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CENTURY DR",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016061244",
            "telephone_number": "508-762-5400",
            "fax_number": "508-762-5410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26 Queen Street, Ground Floor",
            "address_2": "UMMMC, Ambulatory Psychiatry Service",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "01610",
            "country_code": "US",
            "telephone_number": "508-334-2537",
            "fax_number": "508-334-4320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLF CRAIG",
        "first_name": "KELLY",
        "middle_name": "SUZANNE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-30",
        "last_updated": "2018-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "3525",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "10605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "WOLF",
            "middle_name": "SUZANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amanda Wojcik, PA-C
• Kristen Marie Wojcoski
• Gina S Wojnarowicz
• Maya Claire Wold, SLP
• Caroline Wolek, MD
• Gary L Wolf, MD
• Michelle Elise Wolf, MD
• Danielle Wolfe
• Steven H Wolfe
• Timothy Rand Wolfenden, D.D.S.

• Clinical Psychologist in Worcester, MA
• Providers in Worcester, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2018; 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.