Provider Demographics
NPI:1871621789
Name:WOLFE, KIMBERLY J (LICSW/LCSW-C)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:J
Last Name:WOLFE
Suffix:
Gender:F
Credentials:LICSW/LCSW-C
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:J
Other - Last Name:PARROTTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW/LCSW-C
Mailing Address - Street 1:5247 WISCONSIN AVE NW STE 4
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-2012
Mailing Address - Country:US
Mailing Address - Phone:202-686-7699
Mailing Address - Fax:202-362-9633
Practice Address - Street 1:5247 WISCONSIN AVE NW STE 4
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-2012
Practice Address - Country:US
Practice Address - Phone:202-686-7699
Practice Address - Fax:202-362-9633
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2022-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD094821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD000395600Medicaid
MD2108496OtherCIGNA BEHAVIORAL HEALTH
MD9468258OtherPHCS
MD207017OtherJOHN HOPKINS HEALTHCARE LLC