NPIMap

Organization Active NPI

Wolfe Behavioral Health P.C.

  • Clinical Psychologist
  • New Lenox, IL
National Provider Identifier
1356368195
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
WOLFE BEHAVIORAL HEALTH P.C.
Practice address
339 Alana Dr
New Lenox, IL 60451-1766
Phone
(815) 462-3827
Fax
(815) 462-3837
NPI assigned
Jul 17, 2006
Last updated
Feb 12, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2008

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

Authorized official

Name
Dr. Dora Marie Wolfe, PSYD
Title
Licensed Clinical Psychologist
Phone
(815) 462-3827

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X IL Primary

Addresses

Primary practice location

339 Alana Dr
New Lenox, IL 60451-1766

Mailing address

683 Juli Dr
New Lenox, IL 60451-1269
Phone (815) 462-3827

Other identifiers 1

IdentifierTypeStateIssuer
0009932429OtherILBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

11019 Front St
Apt 1W
Mokena, IL 60448
Phone (815) 462-3827

339 Alana Dr
New Lenox, IL 60451
Phone (815) 279-0467

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202774400000",
    "number": "1356368195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "683 JULI DR",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604511269",
            "telephone_number": "815-462-3827",
            "fax_number": "815-462-3837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 ALANA DR",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604511766",
            "telephone_number": "815-462-3827",
            "fax_number": "815-462-3837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOLFE BEHAVIORAL HEALTH P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2008-02-12",
        "status": "A",
        "authorized_official_last_name": "WOLFE",
        "authorized_official_first_name": "DORA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "815-462-3827",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0009932429",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Lenox, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; 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.