Individual provider Active NPI

Jeanne Wolf, L.P.C.,L.M.F.T.

  • Professional Counselor
  • Lake Charles, LA
National Provider Identifier
1881653665
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2873 Issued in LA
Practice address
2829 4TH Ave
150
Lake Charles, LA 70601-7887
Phone
(337) 480-7800
Fax
(337) 474-4552
NPI assigned
Mar 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 843 LA
Professional Counselor 101YP2500X 2873 LA Primary

Addresses

Primary practice location

2829 4TH Ave
150
Lake Charles, LA 70601-7887

Mailing address

2829 4TH Ave
150
Lake Charles, LA 70601-7887
Phone (337) 480-7805

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
843LAMDAddiction (Substance Use Disorder) Counselor
2873LAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
MMG Archer Institute, LLC CurrentSince Jan 1, 2024 Accepting new patients
Southwest Louisiana Hospital Association Inc PastSince May 8, 2022 Accepting new patients

Locations

2829 4th Ave
Ste 150
Lake Charles, LA 70601
Phone (337) 477-7091

Organizations & group practices 2

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": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1881653665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2829 4TH AVE",
            "address_2": "150",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706017887",
            "telephone_number": "337-480-7805",
            "fax_number": "337-474-4552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2829 4TH AVE",
            "address_2": "150",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706017887",
            "telephone_number": "337-480-7800",
            "fax_number": "337-474-4552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "JEANNE",
        "credential": "L.P.C.,L.M.F.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-21",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "LA",
            "license": "843",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "2873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.