Basic Information
| Provider Information | |||||||||
| NPI: | 1700868668 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WOLF | ||||||||
| FirstName: | BARBARA | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 401 S BALLENGER HWY | ||||||||
| Address2: | |||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485323638 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8103421000 | ||||||||
| FaxNumber: | 8103421590 | ||||||||
| Practice Location | |||||||||
| Address1: | G3230 BEECHER RD | ||||||||
| Address2: | |||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485323615 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8103425620 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/16/2005 | ||||||||
| LastUpdateDate: | 06/12/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 6301005468 | MI | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 1017807 | 01 | MCLAREN HEALTH PLAN | OTHER | 1962541318 | 01 | MCLAREN GROUP NPI # | OTHER | 3W831331 | 01 | HEALTH PLUS OF MICHIGAN | OTHER | 056350 | 01 | VALUE OPTIONS | OTHER | 1017806 | 01 | MCLAREN HEALTH PLAN | OTHER | 1017807 | 01 | MCLAREN HEALTH ADVANTAGE | OTHER | 01002470 | 01 | HEALTH PLUS OF MICHIGAN | OTHER | 204404 | 01 | MCLAREN HEALTH PLAN | OTHER | 680B512650 | 01 | BCBSM-BCN-FEP | OTHER | 0P250050 | 01 | MCARE | OTHER | 1017806 | 01 | MCLAREN HEALTH ADVANTAGE | OTHER | 204404 | 01 | MCLAREN HEALTH ADVANTAGE | OTHER |