Provider Demographics
NPI:1821556648
Name:WADE, SARA KATHERINE (LMFT-A)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:KATHERINE
Last Name:WADE
Suffix:
Gender:F
Credentials:LMFT-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 MAGNOLIA ST STE 102
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29306-2324
Mailing Address - Country:US
Mailing Address - Phone:864-216-2278
Mailing Address - Fax:
Practice Address - Street 1:175 MAGNOLIA ST STE 102
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29306-2324
Practice Address - Country:US
Practice Address - Phone:864-216-2278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6559106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist