Provider Demographics
NPI:1659259661
Name:WOLF, ELIZABETH KRISTINA (LLMSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:KRISTINA
Last Name:WOLF
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 W ALLEGAN ST FL 7
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48933-1717
Mailing Address - Country:US
Mailing Address - Phone:248-233-3994
Mailing Address - Fax:517-481-2271
Practice Address - Street 1:115 W ALLEGAN ST FL 7
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48933-1717
Practice Address - Country:US
Practice Address - Phone:248-233-3994
Practice Address - Fax:517-481-2271
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851120760104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker