Provider Demographics
NPI:1891182572
Name:WADE, JULIA (LPC)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:WADE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7537 MENTOR AVE STE 207E
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-5464
Mailing Address - Country:US
Mailing Address - Phone:440-231-0645
Mailing Address - Fax:
Practice Address - Street 1:7537 MENTOR AVE STE 207E
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-5464
Practice Address - Country:US
Practice Address - Phone:440-231-0645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-21
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHX101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health