Provider Demographics
NPI:1164988127
Name:WADE FAMILY SERVICES PLLC
Entity Type:Organization
Organization Name:WADE FAMILY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:NICHOLE
Authorized Official - Last Name:WADE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-443-7303
Mailing Address - Street 1:1901 MEDI PARK DR SUITE 130
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106
Mailing Address - Country:US
Mailing Address - Phone:405-443-7303
Mailing Address - Fax:806-553-6002
Practice Address - Street 1:1901 MEDI PARK DR SUITE 130
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106
Practice Address - Country:US
Practice Address - Phone:405-443-7303
Practice Address - Fax:806-553-6002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-14
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty