Colin Anthony Wolf, LMFT, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C3811 Issued in OR

Practice address

8311 SE 13TH Ave Ste B
Portland, OR 97202-7170

Phone

(503) 389-0398

Fax

(503) 200-1178

NPI assigned

Aug 11, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Rainbow Creative, LLC

  • Mental Health Counselor
  • Portland, OR
  • NPI 1528655263
  NPD Authorized official
• Rainbow Creative, LLC

  • Mental Health Counselor
  • Portland, OR
  • NPI 1578417234
  NPD Authorized official

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

{
    "created_epoch": "1344643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720137600000",
    "number": "1629325477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8311 SE 13TH AVE STE B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972027170",
            "telephone_number": "503-389-0398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8311 SE 13TH AVE STE B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972027170",
            "telephone_number": "503-389-0398",
            "fax_number": "503-200-1178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "COLIN",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "LMFT, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-11",
        "last_updated": "2024-07-05",
        "certification_date": "2024-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C3811",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NY",
            "license": "001436",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Leigh Woldt, MOT, OTR/L
• Justyna Wolek, LCSW
• Wolf Crow Medicine
• Amy Colleen Wolf, L.AC.
• Bryan Michael Wolf, M.D.
• Elizabeth Ann Wolf, LAC
• Fawn Melanie Wolf, M.D.
• Hannah L Wolf, MD
• Iris Wolf, P.T.
• Jackie Marcella Wolf, PT

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.