Individual provider Active NPI

Nathalie Lella Wolk, PHD

  • Counseling Psychologist
  • Houston, TX
National Provider Identifier
1619207842
Registry record updated Dec 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
33328 Issued in TX
Practice address
1128 Waverly St
Houston, TX 77008-6762
Phone
(713) 301-6121
NPI assigned
Jan 11, 2010
Last updated
Dec 30, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 33328 TX Primary

Addresses

Primary practice location

1128 Waverly St
Houston, TX 77008-6762

Mailing address

1128 Waverly St
Houston, TX 77008-6762
Phone (713) 301-6121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120328000885 TX Practitioner - Clinical Psychologist 8527228592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Montrose CenterGroup PAC ID 8325020258, 8 clinicians

Practice addresses (Care Compare)

2222 Cleburne St
Houston, TX 77004-5177
Phone (713) 497-5549

401 Branard St
FL 2
Houston, TX 77006-5015
Phone (713) 529-0037

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
33328TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
The Montrose Center CurrentSince Jan 15, 2012 Accepting new patients
Montrose Counseling Center, Inc. Past Accepting new patients

Locations

401 Branard St
Fl 2
Houston, TX 77006
Phone (713) 529-0037

2222 Cleburne St
Houston, TX 77004
Phone (713) 497-5549

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1263168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325203200000",
    "number": "1619207842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1128 WAVERLY ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770086762",
            "telephone_number": "713-301-6121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1128 WAVERLY ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770086762",
            "telephone_number": "713-301-6121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLK",
        "first_name": "NATHALIE",
        "middle_name": "LELLA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-11",
        "last_updated": "2011-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "TX",
            "license": "33328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.