Provider Demographics
NPI:1124178488
Name:WADE, NAVROOP K (LCSW)
Entity Type:Individual
Prefix:
First Name:NAVROOP
Middle Name:K
Last Name:WADE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3021 HOMEBROOK LN
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-7138
Mailing Address - Country:US
Mailing Address - Phone:919-418-0058
Mailing Address - Fax:
Practice Address - Street 1:10520 LITTLE BRIER CREEK LANE
Practice Address - Street 2:SUITE 205
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-2761
Practice Address - Country:US
Practice Address - Phone:919-371-6928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0055721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical