Provider Demographics
NPI:1659197937
Name:WOLFE, LYNN (LPC)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:WOLFE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10431 FRONTENAC WOODS LN
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-3422
Mailing Address - Country:US
Mailing Address - Phone:314-799-3434
Mailing Address - Fax:
Practice Address - Street 1:130 S BEMISTON AVE STE 710
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:MO
Practice Address - Zip Code:63105-1913
Practice Address - Country:US
Practice Address - Phone:314-669-6519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022048982101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional