Individual provider Active NPI

Laura Wolf

  • Professional Counselor
  • Bastrop, TX
National Provider Identifier
1639664618
Registry record updated Jun 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
79970 Issued in TX
Practice address
909 Pecan St
Bastrop, TX 78602-3819
Phone
(512) 321-3774
NPI assigned
Jun 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 79970 TX Primary

Addresses

Primary practice location

909 Pecan St
Bastrop, TX 78602-3819

Mailing address

1402 Jefferson St
Bastrop, TX 78602-3017
Phone (281) 772-4687

Other identifiers 1

IdentifierTypeStateIssuer
79970OtherTXTEXAS BOARD OF PROFESSIONAL COUNSELORS

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
I20231206000889 TX Practitioner - Mental Health Counselor 3173972932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Centers of South Central Texas, Inc.Group PAC ID 4688650328, 9 clinicians

Practice addresses (Care Compare)

275 Jackson St
Bastrop, TX 78602-4316
Phone (512) 321-7137

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bluebonnet Trails Community MHMR Center CurrentSince Jan 1, 2024 Accepting new patients
Bluebonnet Trails Community MHMR Center Professional CurrentSince Jan 1, 2024 Accepting new patients

Locations

228 Saint George St
Gonzales, TX 78629
Phone (830) 672-6511

1009 N Georgetown St
Round Rock, TX 78664
Phone (512) 244-8374

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529625600000",
    "number": "1639664618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 JEFFERSON ST",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786023017",
            "telephone_number": "281-772-4687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 PECAN ST",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786023819",
            "telephone_number": "512-321-3774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "LAURA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-22",
        "last_updated": "2018-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "79970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF PROFESSIONAL COUNSELORS",
            "identifier": "79970",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bastrop, TX

Sources for this page

Verify at the official NPI Registry.