Individual provider Active NPI

Peter A Wolff, LCPC

  • Professional Counselor
  • Frederick, MD
National Provider Identifier
1477126431
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC11641 Issued in MD
Practice address
116 Record St
Frederick, MD 21701-5418
Phone
(301) 620-8700
Fax
(301) 620-8710
NPI assigned
Jul 19, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LC11641 MD Primary

Addresses

Primary practice location

116 Record St
Frederick, MD 21701-5418

Mailing address

116 Record St
Frederick, MD 21701-5418
Phone (301) 620-8700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 21, 2025 through Apr 21, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LC11641MDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Vital Sources, LLC Professional CurrentSince Jul 25, 2021 Accepting new patients
Pamela Shepp Counseling Past Accepting new patients

Locations

116 Record St
Frederick, MD 21701
Phone (301) 620-8700

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": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1477126431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 RECORD ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217015418",
            "telephone_number": "301-620-8700",
            "fax_number": "301-620-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 RECORD ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217015418",
            "telephone_number": "301-620-8700",
            "fax_number": "301-620-8710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFF",
        "first_name": "PETER",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-19",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC11641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.