Individual ProviderLisa WolffSocial WorkerBehavioral Health & Social Service ProvidersPractice Address6207 Executive Blvd, Rockville, MD 20852-3906(301) 806-8502PECOS EnrollmentBased on the most recent information from CMS, provider Lisa Wolff does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1114246964Provider TypeIndividualFull NameWolff, LisaCredentialM.S.W.GenderFemaleSole ProprietorYesEnumeration Date5/19/2010Last Updated2/22/2017Contact InformationPractice LocationPractice Address6207 Executive Blvd, Rockville, MD 20852-3906Phone(301) 806-8502FaxUnlisted FaxMailing LocationMailing Address11112 Powder Horn Dr, Potomac, MD 20854-2539Phone(301) 806-8502FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense09729MarylandProvider IdentifiersIDDescriptionIssuerIDM3800008DescriptionOtherIssuerCAREFIRSTMarylandID600658604DescriptionOtherIssuerMAGELLANDistrict of ColumbiaID228583DescriptionOtherIssuerJOHNS HOPKINS HEALTH CAREMarylandID3559840DescriptionOtherIssuerCIGNAMarylandID420089600DescriptionMedicaidIssuerUnlistedMaryland