Provider Demographics
NPI:1821029844
Name:KADE, H DENNIS (PHD)
Entity Type:Individual
Prefix:DR
First Name:H
Middle Name:DENNIS
Last Name:KADE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2125 W ADMIRAL DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-1763
Mailing Address - Country:US
Mailing Address - Phone:757-683-8770
Mailing Address - Fax:757-683-9211
Practice Address - Street 1:3210 CHURCHLAND BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-5253
Practice Address - Country:US
Practice Address - Phone:757-483-3404
Practice Address - Fax:757-483-0461
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001680103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7712120Medicaid
VA081517MOtherOPTIMA
VA257107OtherANTHEM