Provider Demographics
NPI:1083368393
Name:EARLS, WILLIAM WADE (MA)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:WADE
Last Name:EARLS
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2251 CRAWFORD ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47803-2566
Mailing Address - Country:US
Mailing Address - Phone:812-240-5391
Mailing Address - Fax:
Practice Address - Street 1:2100 S LIBERTY DR STE A
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403-5147
Practice Address - Country:US
Practice Address - Phone:812-727-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-06
Last Update Date:2022-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)