Mykel Wolfe, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.018383 Issued in IL

Practice address

2401 W Main St
Marion, IL 62959-1188

Phone

(314) 346-1667

NPI assigned

Apr 1, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Shine Medical Providers PC

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1538894050
  NPD (past)

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

{
    "created_epoch": "1459468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1205299781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 W WALNUT ST",
            "address_2": "APT. D",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629592744",
            "telephone_number": "618-841-4898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W MAIN ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629591188",
            "telephone_number": "314-346-1667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFE",
        "first_name": "MYKEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-01",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.018383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bobbie Jo Wink
• Adam Winkeler, O.D.
• Laura Marie Winslow, RN
• Melissa Marie Wisniewski, OD
• Vicky Kay Wolf, RN BSN MSN
• Bonnie Womack
• Carla Wood
• Cassandra Wood, PAC
• Laurie Woodhouse, MA,LPC
• David Woods

• Clinical Social Worker in Marion, IL
• Providers in Marion, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.