Individual provider Active NPI

Stephanie Susanne Genser Wolf, JD PHD

  • Psychologist
  • Bethesda, MD
National Provider Identifier
1780129098
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
05511 Issued in MD
Practice address
5614 Shields Dr
Bethesda, MD 20817-3532
Phone
(202) 255-2370
NPI assigned
Dec 21, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 05511 MD Primary

Addresses

Primary practice location

5614 Shields Dr
Bethesda, MD 20817-3532

Mailing address

5614 Shields Dr
Bethesda, MD 20817-3532
Phone (202) 255-2370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Sep 29, 2025 through Sep 29, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Juris Doctor, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
05511MDMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1482278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1780129098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5614 SHIELDS DR",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208173532",
            "telephone_number": "202-255-2370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5614 SHIELDS DR",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208173532",
            "telephone_number": "202-255-2370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "STEPHANIE",
        "middle_name": "SUSANNE GENSER",
        "name_prefix": "Dr.",
        "credential": "JD PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-21",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "05511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.