Benjamin J Wolf, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

16965 Issued in MN

Practice address

13750 Crosstown Dr NW
Suite L101
Andover, MN 55304-5853

Phone

(763) 482-9598

NPI assigned

May 25, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Sep 14, 2015 through Sep 14, 2027

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Hope & Healing for Life PLLC

  • Clinical Social Worker
  • Saint Paul, MN
  • NPI 1851685721
  NPD (past) Authorized official

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1538370820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11105 ZEBULON PIKE AVE",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553371151",
            "telephone_number": "612-802-9398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13750 CROSSTOWN DR NW",
            "address_2": "SUITE L101",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553045853",
            "telephone_number": "763-482-9598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "BENJAMIN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "16965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Williams
• Kathryn Rose Williams, PT, DPT
• Emily Wilson
• Mark H Winholtz
• Kimberley Wobschall, MA, LMFT
• Olivia McKay Wolff-Herda, MA
• Michelle Wong
• Crystal Ann Marie Yaekel, COTA
• Christina Nguyen Yang
• Alicia M Yantes, O.D.

• Clinical Social Worker in Andover, MN
• Providers in Andover, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.