Provider Demographics
NPI:1902069818
Name:WOLFF, JOHN (MA, LAMFT)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:WOLFF
Suffix:
Gender:M
Credentials:MA, LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 EUSTIS ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55108-1219
Mailing Address - Country:US
Mailing Address - Phone:651-646-6393
Mailing Address - Fax:651-635-0454
Practice Address - Street 1:2230 COMO AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55108-1720
Practice Address - Country:US
Practice Address - Phone:651-255-2233
Practice Address - Fax:651-635-0454
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1840106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist