Provider Demographics
NPI:1205918737
Name:WOLFSON, NANCY K (MSW)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:K
Last Name:WOLFSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3916 LELAND ST
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-5036
Mailing Address - Country:US
Mailing Address - Phone:301-657-2314
Mailing Address - Fax:301-657-2307
Practice Address - Street 1:10400 CONNECTICUT AVE
Practice Address - Street 2:SUITE #300
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-3910
Practice Address - Country:US
Practice Address - Phone:301-509-2429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD092001041C0700X
DCLC3028121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
490034Medicare ID - Type Unspecified