BRIAN A WOLF (NPI# 1609982040) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609982040 |
| Entity Type | Individual |
| Full Name | BRIAN A WOLF |
| Credential | PH.D. |
| Practice Address |
2108 63rd St Kenosha WI 53143-4454 |
| Mailing Address |
6233 39th Ave Kenosha WI 53142-7015 |
| Practice Telephone | 2626522406 |
| Practice Fax Number | 2626522408 |
| Mailing Telephone | 2626541004 |
| Mailing Fax Number | 2626546960 |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2008-06-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
12126 | WI | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
1039-057 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 39046000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154610491 | Brian A Wolf | Internal Medicine | 880 W Central Rd Ste 8100, Arlington Heights, IL 60005-2391 | 2011-04-06 |
| 1538147244 | Brian E Wolf | Internal Medicine | 3024 Pickett Rd, Durham, NC 27705-6006 | 2006-01-03 |
| 1730640772 | Brian Wolf | Student in an Organized Health Care Education/Training Program | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2019-03-30 |
| 1467813394 | Brian Wolf | Student in an Organized Health Care Education/Training Program | 1 Robert Wood Johnson Pl, New Brunswick, NJ 08901-1928 | 2016-03-20 |
| 1407247307 | Brian Alexander Wolf | Psychiatry & Neurology | 1921 Waldemere St Ste 701, Sarasota, FL 34239 | 2015-02-12 |
| 1437594363 | Brian C Wolf | Preventive Medicine | 411 Meadowlark St, Shaw Afb, SC 29152 | 2013-05-06 |
| 1902249030 | Brian Patrick Wolf | Pharmacist | 8500 W Capitol Dr, Milwaukee, WI 53222-1869 | 2013-04-08 |
| 1316042708 | Brian E Wolf | Surgery | 100 South St, Southbridge, MA 01550-4051 | 2006-09-13 |
| 1255326732 | Brian R Wolf | Orthopaedic Surgery | 200 Hawkins Dr, Iowa City, IA 52242-1009 | 2005-09-12 |
| Street Address |
2108 63RD ST |
| City | KENOSHA |
| State | WI |
| Zip Code | 53143-4454 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033718440 | Mackenzie Dodge | Social Worker | 2108 63rd St, Kenosha, WI 53143-4454 | 2020-10-19 |
| 1194322065 | Susanne Smith | Counselor | 2108 63rd St, Kenosha, WI 53143-4454 | 2020-10-05 |
| 1215540547 | Nicholas Dean Dubios-rose | Counselor | 2108 63rd St, Kenosha, WI 53143-4454 | 2020-08-26 |
| 1972150654 | Nathaniel Willkomann | Counselor | 2108 63rd St, Kenosha, WI 53143-4454 | 2019-08-19 |
| 1710548185 | Megan Schilz | Counselor | 2108 63rd St, Kenosha, WI 53143-4454 | 2019-06-25 |
| 1588122253 | Carissa Johnson | Social Worker | 2108 63rd St, Kenosha, WI 53143-4454 | 2019-03-12 |
| 1386117851 | Sarah Magallon | Counselor | 2108 63rd St, Kenosha, WI 53143-4454 | 2019-01-08 |
| 1992278964 | Jamie-lee Nietupski | Counselor | 2108 63rd St, Kenosha, WI 53143-4454 | 2019-01-02 |
| 1881166189 | Arturo Perez | Counselor | 2108 63rd St, Kenosha, WI 53143-4454 | 2018-12-27 |
| 1669943874 | Amy Macdonald-wojcik | Social Worker | 2108 63rd St, Kenosha, WI 53143-4454 | 2018-12-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891262275 | Shanda L Goecks | Registered Nurse | 6916 26th Ave, Kenosha, WI 53143 | 2018-10-24 |
| 1689942989 | Racine Kenosha Community Action Agency | Public Health or Welfare | 2000 63rd Street, Kenosha, WI 53143 | 2011-12-01 |
| 1538497797 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 7525 Sheridan Rd, Kenosha, WI 53143 | 2009-11-30 |
| 1497929012 | Ebba M Johnson | Physical Therapist | 524 74th Street, Kenosha, WI 53143 | 2008-04-15 |
| 1770789489 | Kenosha Community Health Center, Inc | Family Medicine | 6226 14th Ave, Kenosha, WI 53143 | 2007-06-21 |
| 1558413161 | Junith M Thompson | Obstetrics & Gynecology | 6530 Sheridan Road, Kenosha, WI 53143 | 2007-01-17 |
| 1154471332 | Ljh Ambulance, Inc | Ambulance | 6329 28th Ave, Kenosha, WI 53143 | 2007-01-11 |
| 1578625794 | Michael A Schellpfeffer Md Ob Gyn Sc | Obstetrics & Gynecology | 1400 75th Street, Kenosha, WI 53143 | 2006-12-14 |
| 1457468654 | Yasmine S Sido | Physician Assistant | 7550 22nd Ave, Kenosha, WI 53143 | 2006-08-24 |
| 1356307359 | Nancy Jane Houtchens | Dentist | 7533 22nd Ave, Ste 100, Kenosha, WI 53143 | 2006-04-26 |
| Find all providers in zip 53143 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558619379 | Leah J Featherstone | Psychologist | 2108-63 Street, Kenosha, WI 53143-4454 | 2012-08-28 |
| 1336412360 | Kristin M Keeler, S.c | Psychologist | 4217 Green Bay Rd, Kenosha, WI 53144-4518 | 2012-02-22 |
| 1497957724 | Janice Alberdiena Vanniel | Psychologist | 7807 15th Ave, Kenosha, WI 53143-5913 | 2007-05-31 |
| 1821345372 | Dana Michelle Ballewske | Psychologist | 2108 63rd St, Kenosha, WI 53143-4454 | 2012-08-14 |
| 1124213954 | Michael Matthew Mihajlovic | Psychologist | 4536 22nd Ave, Kenosha, WI 53140-5917 | 2007-09-14 |
| 1487868584 | Kristin Marie Keeler | Psychologist | 5024 Green Bay Rd, Suite 120, Kenosha, WI 53144-1702 | 2007-05-09 |
| 1780769810 | Verna F. Christy | Psychologist | 5017 Green Bay Rd Ste 130, Kenosha, WI 53144-1782 | 2006-10-26 |
| 1467537423 | Debra Johansen | Psychologist | 6121 Green Bay Rd, Suite 230, Kenosha, WI 53142-2926 | 2006-10-26 |
| 1952482267 | Leesa Marie Wiedholz-abbott | Psychologist | 3734 7th Ave, Suite 12, Kenosha, WI 53140-5525 | 2006-10-17 |
| 1649291923 | Kalpana Rao | Psychologist | 6123 Green Bay Rd, Kenosha, WI 53142-2927 | 2006-07-21 |
| Find all providers in KENOSHA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.