Provider Demographics
NPI:1881920072
Name:JONES, WADE GIRARD (LPCMH, LCDP, CADC)
Entity type:Individual
Prefix:
First Name:WADE
Middle Name:GIRARD
Last Name:JONES
Suffix:
Gender:M
Credentials:LPCMH, LCDP, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2015
Mailing Address - Street 2:1003 HOUSTON ACRES
Mailing Address - City:MILLSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19966-8015
Mailing Address - Country:US
Mailing Address - Phone:302-542-3586
Mailing Address - Fax:866-648-7571
Practice Address - Street 1:1003 HOUSTON ACRES
Practice Address - Street 2:
Practice Address - City:MILLSBORO
Practice Address - State:DE
Practice Address - Zip Code:19966-3568
Practice Address - Country:US
Practice Address - Phone:302-542-3586
Practice Address - Fax:866-648-7571
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-23
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000625101YM0800X
DECD-0000050101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)