Individual provider · Type 1 NPI

Carla Jo Wade, LCAC, LMLP

Addiction (Substance Use Disorder) Counselor · Wichita, KS

NPI number 1205597416 Active

Practice location

3820 N Toben St
Wichita, KS 67226-2903

Fax (316) 634-3956

Mailing address

130 E 5th St
Newton, KS 67114-2206

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400X953 (KS)
Addiction (Substance Use Disorder) Counselor 101YA0400X247 (KS)
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X10848 (KS)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1205597416

Carla Jo Wade, LCAC, LMLP's National Provider Identifier is 1205597416, issued on Jan 10, 2022. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Wichita, KS. The record was last updated on Jan 10, 2022.