Individual provider · Type 1 NPI
Jonathan Lewis Wade Sr., M.DIV.
Addiction (Substance Use Disorder) Counselor · Brookhaven, PA
NPI number
1366795890
Active
Practice location
5000 Hilltop Dr
Brookhaven, PA 19015-1228
Fax (610) 876-4534
Mailing address
201 Blackwood Clementon Rd, Apt. 1901
Lindenwold, NJ 08021-6878
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | None listed |
| Mental Health Counselor | 101YM0800X | None listed |
| Pastoral Counselor | 101YP1600X | None listed |
Addiction (Substance Use Disorder) Counselor: Definition to come...
Another provider at this address
About NPI 1366795890
Jonathan Lewis Wade Sr., M.DIV.'s National Provider Identifier is 1366795890, issued on Oct 22, 2012. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Brookhaven, PA. The record was last updated on Oct 22, 2012.