Provider Demographics
NPI:1467328526
Name:WOLFE, VICTORIA LAKE (LMSW)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:LAKE
Last Name:WOLFE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 LIMESTONE RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-2635
Mailing Address - Country:US
Mailing Address - Phone:203-998-1541
Mailing Address - Fax:
Practice Address - Street 1:415 MAIN ST
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4500
Practice Address - Country:US
Practice Address - Phone:860-470-6793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-15
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT11725101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health