Individual provider Active NPI

Marlene M Wolf, LMFT

  • Marriage & Family Therapist
  • Stamford, CT
National Provider Identifier
1861970949
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
002016 Issued in CT
Practice address
1200 High Ridge Rd
Stamford, CT 06905-1223
Phone
(203) 856-9852
NPI assigned
Aug 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 002016 CT Primary

Addresses

Primary practice location

1200 High Ridge Rd
Stamford, CT 06905-1223

Mailing address

22 Tryon Ave
Rumford, RI 02916-1834
Phone (203) 856-9852

Other identifiers 1

IdentifierTypeStateIssuer
004069985MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20240212002875 CT Practitioner - Marriage and Family Therapist 7315380862 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

121 Towne St
Apt 617
Stamford, CT 06902-5945
Phone (203) 856-9852

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002016CTMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Marlene M Wolf, LLC Marriage & Family Therapist CurrentSince Feb 1, 2024 Accepting new patients

Locations

1200 High Ridge Rd
Stamford, CT 06905
Phone (203) 539-0845

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": "1533081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1861970949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 TRYON AVE",
            "city": "RUMFORD",
            "state": "RI",
            "postal_code": "029161834",
            "telephone_number": "203-856-9852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 HIGH RIDGE RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069051223",
            "telephone_number": "203-856-9852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "MARLENE",
        "middle_name": "M",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-01",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "002016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004069985",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.