Provider Demographics
NPI:1285815480
Name:WADE, LINDA NORMAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:NORMAN
Last Name:WADE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1565 BAPTIST CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-5812
Mailing Address - Country:US
Mailing Address - Phone:914-962-6825
Mailing Address - Fax:914-962-4619
Practice Address - Street 1:23 PARKWAY
Practice Address - Street 2:
Practice Address - City:KATONAH
Practice Address - State:NY
Practice Address - Zip Code:10536-1505
Practice Address - Country:US
Practice Address - Phone:914-232-2337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012186-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical