Active NPI
Cody Owen Wolf
- Behavior Technician
- Traverse City, MI
National Provider Identifier
1629909684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- W900001923141
- Practice address
- 10781 E Cherry Bend Rd
Traverse City, MI 49684-5249 - Phone
- (800) 645-4737
- Fax
- (231) 525-3170
- NPI assigned
- May 28, 2026
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | W900001923141 | MI | Primary |
Addresses
Primary practice location
10781 E Cherry Bend Rd
Traverse City, MI 49684-5249
Mailing address
10781 E Cherry Bend Rd
Traverse City, MI 49684-5249
Phone (800) 645-4737
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 |
|---|---|---|---|
| W900001923141 | MI | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1779926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779926400000",
"number": "1629909684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10781 E CHERRY BEND RD",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496845249",
"telephone_number": "800-645-4737",
"fax_number": "231-525-3170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10781 E CHERRY BEND RD",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496845249",
"telephone_number": "800-645-4737",
"fax_number": "231-525-3170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLF",
"first_name": "CODY",
"middle_name": "OWEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-05-28",
"last_updated": "2026-05-28",
"certification_date": "2026-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MI",
"license": "W900001923141",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.