Active NPI
Jendel Wolfe, PLPC
- Professional Counselor
- Mount Vernon, MO
National Provider Identifier
1164292330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2022045285
- Practice address
- 15424 Lawrence 1110
Mount Vernon, MO 65712-9311 - Phone
- (176) 696-6924
- NPI assigned
- Jan 8, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2022045285 | MO | Primary |
Addresses
Primary practice location
15424 Lawrence 1110
Mount Vernon, MO 65712-9311
Mailing address
15424 Lawrence 1110
Mount Vernon, MO 65712-9311
Phone (417) 669-6692
Other practice location 1
210 S Adams Ave
Aurora, MO 65605-1404
Phone (417) 501-4543
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 26, 2024 through Dec 26, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2022045285 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704672000000",
"number": "1164292330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15424 LAWRENCE 1110",
"city": "MOUNT VERNON",
"state": "MO",
"postal_code": "657129311",
"telephone_number": "417-669-6692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15424 LAWRENCE 1110",
"city": "MOUNT VERNON",
"state": "MO",
"postal_code": "657129311",
"telephone_number": "176-696-6924"
}
],
"practiceLocations": [
{
"address_1": "210 S Adams Ave",
"address_purpose": "LOCATION",
"city": "Aurora",
"state": "MO",
"postal_code": "656051404",
"country_code": "US",
"telephone_number": "417-501-4543",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WOLFE",
"first_name": "JENDEL",
"credential": "PLPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-08",
"last_updated": "2024-01-08",
"certification_date": "2024-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2022045285",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.