Provider Demographics
NPI:1245806090
Name:LUQUET, WADE (MSW, PHD)
Entity Type:Individual
Prefix:DR
First Name:WADE
Middle Name:
Last Name:LUQUET
Suffix:
Gender:M
Credentials:MSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:842 PATTERSON DR
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-5432
Mailing Address - Country:US
Mailing Address - Phone:215-390-6321
Mailing Address - Fax:
Practice Address - Street 1:100 S MAIN ST STE 2B
Practice Address - Street 2:
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-2847
Practice Address - Country:US
Practice Address - Phone:215-699-4404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0177311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical