Individual provider Active NPI

Christine Jeanne Wolf, LMHC- 8328

  • Mental Health Counselor
  • Fort Pierce, FL
National Provider Identifier
1649822602
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
8328 Issued in FL
Practice address
4500 W Midway Rd
Fort Pierce, FL 34981-4823
Phone
(888) 468-5600
NPI assigned
Jul 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 8328 FL Primary

Addresses

Primary practice location

4500 W Midway Rd
Fort Pierce, FL 34981-4823

Mailing address

4500 W Midway Rd
Fort Pierce, FL 34981-4823
Phone (888) 468-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20240924000106 CO Practitioner - Marriage and Family Therapist 9133660749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Joseph Yeretsian PCGroup PAC ID 5597893313, 13 clinicians

Practice addresses (Care Compare)

155 Boardwalk Dr
Suite 400
Fort Collins, CO 80525-3040
Phone (970) 549-0235

4770 Baseline Rd
Suite 300
Boulder, CO 80303-2669
Phone (720) 798-4516

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8328FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph Yeretsian, P.C. CurrentSince Sep 18, 2024 Accepting new patients

Locations

4770 Baseline Rd
Ste 300
Boulder, CO 80303
Phone (720) 798-4516

155 Boardwalk Dr
Ste 400
Fort Collins, CO 80525
Phone (970) 549-0235

Organizations & group practices 1

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": "1562716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1649822602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 W MIDWAY RD",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349814823",
            "telephone_number": "888-468-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 W MIDWAY RD",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349814823",
            "telephone_number": "888-468-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "CHRISTINE",
        "middle_name": "JEANNE",
        "credential": "LMHC- 8328",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-10",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "8328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

Verify at the official NPI Registry.