Individual provider Active NPI

Daniel Jonathan Wolf, LMHC

  • Mental Health Counselor
  • Brookline, MA
National Provider Identifier
1194333575
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
11825 Issued in MA
Practice address
7 Kent St
Brookline, MA 02445-7959
Phone
(617) 738-1480
NPI assigned
Jul 21, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 11825 MA Primary

Addresses

Primary practice location

7 Kent St
Brookline, MA 02445-7959

Mailing address

102 Hooker St
Allston, MA 02134-1233
Phone (857) 540-0325

Other practice location 1

102 Hooker St
Allston, MA 02134-1233
Phone (857) 540-0325

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
11825MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Evening Therapy Associates, LLC CurrentSince Aug 2, 2020 Accepting new patients

Locations

2001 Beacon St
Ste 308
Brighton, MA 02135
Phone (617) 738-1480

7 Kent St
Brookline, MA 02445
Phone (617) 730-4344

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": "1595289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1194333575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 HOOKER ST",
            "city": "ALLSTON",
            "state": "MA",
            "postal_code": "021341233",
            "telephone_number": "857-540-0325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 KENT ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024457959",
            "telephone_number": "617-738-1480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 Hooker St",
            "address_purpose": "LOCATION",
            "city": "Allston",
            "state": "MA",
            "postal_code": "021341233",
            "country_code": "US",
            "telephone_number": "857-540-0325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLF",
        "first_name": "DANIEL",
        "middle_name": "JONATHAN",
        "name_prefix": "Mr.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-21",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "11825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; 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.