Basic Information
Provider Information
NPI: 1780008979
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WOOLF
FirstName: SCOTT
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.ED.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2030 W TILGHMAN ST
Address2: SUITE 105-B
City: ALLENTOWN
State: PA
PostalCode: 181044354
CountryCode: US
TelephoneNumber: 4842219136
FaxNumber: 4842219130
Practice Location
Address1: 865 E 4TH ST
Address2:  
City: BETHLEHEM
State: PA
PostalCode: 180151935
CountryCode: US
TelephoneNumber: 6106914357
FaxNumber: 6106912517
Other Information
ProviderEnumerationDate: 02/10/2014
LastUpdateDate: 04/02/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health
101YS0200X  N Behavioral Health & Social Service ProvidersCounselorSchool

No ID Information.


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