Individual provider Active NPI

Cynthia Marie Wolf, LMHC, NCC

  • Mental Health Counselor
  • Vancouver, WA
National Provider Identifier
1336789429
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH61358650 Issued in WA
Practice address
1498 SE Tech Center PL Ste 300
Vancouver, WA 98683-5509
Phone
(360) 619-2226
Fax
(360) 326-9691
NPI assigned
Jan 7, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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 LH61358650 WA Primary

Addresses

Primary practice location

1498 SE Tech Center PL Ste 300
Vancouver, WA 98683-5509

Mailing address

15216 NE 50TH St
Vancouver, WA 98682-6048
Phone (360) 836-1687

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20240807004654 WA Practitioner - Mental Health Counselor 1456898402 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LH61358650WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Real Life Community Behavioral Health PLLC Mental Health CurrentSince Dec 8, 2024 Accepting new patients

Locations

1498 SE Tech Center Pl
Ste 180
Vancouver, WA 98683
Phone (360) 200-8670

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1578355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1336789429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15216 NE 50TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986826048",
            "telephone_number": "360-836-1687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1498 SE TECH CENTER PL STE 300",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986835509",
            "telephone_number": "360-619-2226",
            "fax_number": "360-326-9691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "CYNTHIA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LMHC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-07",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61358650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.