Provider Demographics
NPI:1447493697
Name:WOLFE, SUSAN STALLINGS (LPC, NCC)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:STALLINGS
Last Name:WOLFE
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:JANE
Other - Last Name:FRENCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:222 S MERAMEC AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105-3514
Mailing Address - Country:US
Mailing Address - Phone:314-717-1727
Mailing Address - Fax:
Practice Address - Street 1:222 S MERAMEC AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63105-3514
Practice Address - Country:US
Practice Address - Phone:314-717-1727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-16
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009001523101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional