Individual provider Active NPI

Linda A Wolf, MS, NBCC, LPC

  • Mental Health Counselor
  • Summerville, SC
National Provider Identifier
1912498650
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
7469 Issued in SC
Practice address
627 Old Trolley Rd Ste a
Summerville, SC 29485-5673
Phone
(800) 552-4357
Fax
(678) 388-9244
NPI assigned
May 29, 2018
Last updated
Aug 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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 7469 SC Primary

Addresses

Primary practice location

627 Old Trolley Rd Ste a
Summerville, SC 29485-5673

Mailing address

173 Braly Dr
Summerville, SC 29485-5317
Phone (843) 990-1262

Other practice location 1

173 Braly Dr
Summerville, SC 29485-5317
Phone (843) 990-1262

Other practice location 2

201 Sigma Dr Ste 300
Summerville, SC 29486-7722
Phone (800) 552-4357

Other identifiers 1

IdentifierTypeStateIssuer
PC2892MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20240604000501 SC Practitioner - Mental Health Counselor 6204378433 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Mental Health Current Accepting new patients
Synergy Counseling Services LLC Mental Health CurrentSince Apr 1, 2024 Accepting new patients
Covenant Counseling of South Carolina PastSince Jun 12, 2009 Accepting new patients

Locations

1710 Trolley Rd
Ste E
Summerville, SC 29485
Phone 8005524357106

201 Sigma Dr
Ste 300
Summerville, SC 29486
Phone (843) 260-5361

627 Trolley Rd
Ste A
Summerville, SC 29485
Phone 8005524357109

141 Wildwood Dr
Walterboro, SC 29488
Phone (843) 549-7813

Interoperability endpoints

  • Direct secure messaging: lindawolf@tdh.allscriptsdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1527552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1912498650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 BRALY DR",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294855317",
            "telephone_number": "843-990-1262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 OLD TROLLEY RD STE A",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294855673",
            "telephone_number": "800-552-4357",
            "fax_number": "678-388-9244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "173 Braly Dr",
            "address_purpose": "LOCATION",
            "city": "Summerville",
            "state": "SC",
            "postal_code": "294855317",
            "country_code": "US",
            "telephone_number": "843-990-1262",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 Sigma Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Summerville",
            "state": "SC",
            "postal_code": "294867722",
            "country_code": "US",
            "telephone_number": "800-552-4357",
            "fax_number": "678-388-9244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLF",
        "first_name": "LINDA",
        "middle_name": "A",
        "credential": "MS, NBCC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-29",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "7469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PC2892",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.