Provider Demographics
NPI:1043441033
Name:WADE, HELENA B (LCSW)
Entity Type:Individual
Prefix:MS
First Name:HELENA
Middle Name:B
Last Name:WADE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:HELENA
Other - Middle Name:B
Other - Last Name:POMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, ASW
Mailing Address - Street 1:4700 SPRING ST STE 203
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-0273
Mailing Address - Country:US
Mailing Address - Phone:619-549-0329
Mailing Address - Fax:
Practice Address - Street 1:4700 SPRING ST
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942
Practice Address - Country:US
Practice Address - Phone:619-591-5740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-07
Last Update Date:2021-10-28
Deactivation Date:2020-02-18
Deactivation Code:
Reactivation Date:2020-02-26
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA851181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health