Active NPI
Laura Jean Wolfe, LCPC
- Mental Health Counselor
- Bolingbrook, IL
National Provider Identifier
1487788170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 180006228
- Practice address
- 682 W Boughton Rd
Suite D
Bolingbrook, IL 60440-5700 - Phone
- (630) 771-0144
- Fax
- (630) 771-9520
- NPI assigned
- Mar 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 180006228 | IL | Primary |
Addresses
Primary practice location
682 W Boughton Rd
Suite D
Bolingbrook, IL 60440-5700
Mailing address
682 W Boughton Rd
Suite D
Bolingbrook, IL 60440-5700
Phone (630) 771-0144
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09932036 | Other | IL | BCBS PROVIDER NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180006228 | IL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321488000000",
"number": "1487788170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "682 W BOUGHTON RD",
"address_2": "SUITE D",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604405700",
"telephone_number": "630-771-0144",
"fax_number": "630-771-9520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "682 W BOUGHTON RD",
"address_2": "SUITE D",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604405700",
"telephone_number": "630-771-0144",
"fax_number": "630-771-9520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLFE",
"first_name": "LAURA",
"middle_name": "JEAN",
"name_prefix": "Mrs.",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-15",
"last_updated": "2011-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IL",
"license": "180006228",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "09932036",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bolingbrook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.