Marissa Wolfe, MA, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-22-60654 Issued in IL

Practice address

301 S Vine St Unit 10
Urbana, IL 61801-7404

Phone

(224) 298-7462

NPI assigned

Aug 11, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

Practice roles

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.

• Autism Evaluation Center at the Place

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1104772987
  NPD (past)
• Djje Holdings LLC

  • Behavior Analyst
  • Chicago, IL
  • NPI 1477001766
  NPD (past)
• The Place for Speech Therapy LLC

  • Speech-Language Pathologist
  • Chicago, IL
  • NPI 1568923621
  NPD (past)

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

{
    "created_epoch": "1597104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1760093967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8609 W BRYN MAWR AVE STE 204",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606313524",
            "telephone_number": "773-644-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S VINE ST UNIT 10",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618017404",
            "telephone_number": "224-298-7462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8609 W Bryn Mawr Ave Ste 204",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606313524",
            "country_code": "US",
            "telephone_number": "773-644-7787 x1022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLFE",
        "first_name": "MARISSA",
        "credential": "MA, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-11",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "1-22-60654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Witowski, CNM, PMHNP
• Sue Wittman
• Krzysztof Wlosek, APN
• Elias Nigussie Woldegabriel, M.D
• Richard M Wolf, MD
• Nicole Leann Wolken, PA-C
• Angela Wolske
• Landon Wood, MD
• Tyler Wood, MS, ATC
• Joanne Marie Woodard, P.T.

• Behavior Analyst in Urbana, IL
• Providers in Urbana, IL by specialty
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.