Provider Demographics
NPI:1568534154
Name:WADE, ANNA KATHERINE (LMFT)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:KATHERINE
Last Name:WADE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4404 BARBARA DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-4402
Mailing Address - Country:US
Mailing Address - Phone:603-380-1541
Mailing Address - Fax:
Practice Address - Street 1:5410 HOMBERG DR
Practice Address - Street 2:SUITE 14
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5031
Practice Address - Country:US
Practice Address - Phone:865-588-3173
Practice Address - Fax:865-588-3174
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN809106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist