KRISTINA WADE


Address: 1015 Chestnut St, Ste 403, Philadelphia, PA 19107-4316
Phone: 2156259770

KRISTINA WADE (NPI# 1790010601) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1790010601
Entity Type Individual
Full Name KRISTINA WADE
Credential LPC
Practice Address 1015 Chestnut St
Ste 403
Philadelphia
PA 19107-4316
Practice Telephone 2156259770
Mailing Telephone 2156259770
Enumeration Date 2009-10-09
Last Update Date 2009-10-09
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YP2500X Counselor
Specialization: Professional
PC005213 PA Behavioral Health & Social Service Providers

Office Location

Street Address 1015 CHESTNUT ST
STE 403
City PHILADELPHIA
State PA
Zip Code 19107-4316

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1659759678 Stephen Peter Gadomski II Student in an Organized Health Care Education/Training Program 1015 Chestnut St, Suite 620, Philadelphia, PA 19107-4316 2015-05-11
1649667700 Courtney Lee Devin Student in an Organized Health Care Education/Training Program 1015 Chestnut St, Suite 620, Philadelphia, PA 19107-4316 2015-04-16
1710374848 Ellen Caparosa Student in an Organized Health Care Education/Training Program 1015 Chestnut St, Suite 620, Philadelphia, PA 19107-4316 2015-04-15
1275929309 Geoffrey Kozak Student in an Organized Health Care Education/Training Program 1015 Chestnut St, Suite 620, Philadelphia, PA 19107-4316 2015-04-15
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
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1043779630 Heather Lynn Yenser Nurse Practitioner 111 S. 11th St., Jefferson Vascular Center (6th Floor), Philadelphia, PA 19107 2019-03-14
1174093702 Jennifer Lynn Kengeter Psychologist 900 Walnut Street, Suite 200, Philadelphia, PA 19107 2018-11-27
1649751843 Rachel Wint Physician Assistant 231 N Broad St Fl 2, Philadelphia, PA 19107 2018-08-24
1922588623 Hyung Bin Lee Dentist 315 N 12th St, Apt 803, Philadelphia, PA 19107 2018-08-21
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Taxonomy Information

Taxonomy Code 101YP2500X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Professional

Taxonomy Definition

Definition to come...

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Competitor

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City PHILADELPHIA
Zip Code 19107

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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