Individual provider Active NPI

Warren Randal Taylor Wolfe III, MSW, LCSW

  • Student in an Organized Health Care Education/Training Program
  • Winston Salem, NC
National Provider Identifier
1952989014
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1920 W 1St St
Winston Salem, NC 27104-4220
Phone
(336) 716-4479
NPI assigned
Mar 31, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904009666 VA
Student in an Organized Health Care Education/Training Program 390200000X NC Primary

Addresses

Primary practice location

1920 W 1St St
Winston Salem, NC 27104-4220

Mailing address

2333 Ardmore Ter Apt D
Winston Salem, NC 27103-2100
Phone (540) 256-7989

Other practice location 1

136 W Elizabeth St
Harrisonburg, VA 22802-3811
Phone (540) 564-5104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260614000155 NC Order and Referring Only - Family PracticePractitioner - Family Practice 8224438494

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904009666VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1952989014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 ARDMORE TER APT D",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032100",
            "telephone_number": "540-256-7989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 W 1ST ST",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271044220",
            "telephone_number": "336-716-4479"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "136 W Elizabeth St",
            "address_purpose": "LOCATION",
            "city": "Harrisonburg",
            "state": "VA",
            "postal_code": "228023811",
            "country_code": "US",
            "telephone_number": "540-564-5104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLFE",
        "first_name": "WARREN",
        "middle_name": "RANDAL TAYLOR",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-31",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904009666",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.