Individual provider Active NPI

David Francis Wolff, PSYCHOLOGIST

  • Clinical Psychologist
  • Burlington, WI
National Provider Identifier
1275014029
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
513757 Issued in WI
Practice address
197 W Chestnut St
Burlington, WI 53105-1200
Phone
(262) 763-9191
NPI assigned
Aug 28, 2018
Last updated
Mar 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 513757 WI Primary

Addresses

Primary practice location

197 W Chestnut St
Burlington, WI 53105-1200

Mailing address

197 W Chestnut St
Burlington, WI 53105-1200
Phone (262) 763-9191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250324001468 WI Practitioner - Clinical Psychologist 8325560956 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinical Psychology Associates LLCGroup PAC ID 4284041740, 3 clinicians

Practice addresses (Care Compare)

197 W Chestnut St
Suite 100
Burlington, WI 53105-1200
Phone (262) 763-9191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
513757WIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Psychology Associates, LLC Clinical CurrentSince Mar 18, 2025 Accepting new patients
Odyssey Healthcare Operating B, LP PastSince Mar 18, 2025 Accepting new patients

Locations

197 W Chestnut St
Ste 100
Burlington, WI 53105
Phone (262) 763-9191

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1275014029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "197 W CHESTNUT ST",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051200",
            "telephone_number": "262-763-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 W CHESTNUT ST",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051200",
            "telephone_number": "262-763-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFF",
        "first_name": "DAVID",
        "middle_name": "FRANCIS",
        "name_prefix": "Mr.",
        "credential": "PSYCHOLOGIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-28",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "513757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, WI

Sources for this page

Verify at the official NPI Registry.