MR. BRUCE WADE SELVAGE JR. (NPI# 1851420467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851420467 |
| Entity Type | Individual |
| Full Name | MR. BRUCE WADE SELVAGE JR. |
| Credential | MS |
| Practice Address |
1690 Greendale Dr Ne Cleveland TN 37323-5920 |
| Practice Telephone | 4237155576 |
| Mailing Telephone | 4237155576 |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
1882 | TN | Behavioral Health & Social Service Providers |
| Street Address |
1690 GREENDALE DR NE |
| City | CLEVELAND |
| State | TN |
| Zip Code | 37323-5920 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477066082 | Quadmed Medical Clinics of Wisconsin, S.c. D/b/a Quadmed Medical Group | Registered Nurse | 2525 Benton Pike Ne, Cleveland, TN 37323 | 2017-11-06 |
| 1679877518 | Life Bridges, Inc. | Intermediate Care Facility, Mentally Retarded | 207 Kile Lake Road, Cleveland, TN 37323 | 2011-01-07 |
| 1376847251 | Life Bridges, Inc. | Intermediate Care Facility, Mentally Retarded | 209 Kile Lake Road, Cleveland, TN 37323 | 2011-01-06 |
| 1508084302 | Karen Elizabeth Gannon | Nurse Practitioner | 11111 Doctor's Office Tower, 2200 Children's Way, Nashville, TN 37323 | 2007-04-24 |
| 1235353566 | Melissa D Townsend | Specialist/Technologist, Other | 120 Fern Drive, Cleveland, TN 37323 | 2007-04-11 |
| 1306965686 | David Wayne Miolen | Dentist | 2648 Apd 40, Cleveland, TN 37323 | 2007-03-28 |
| 1780751933 | Linda Fay Wooten | Driver | 2259 Spring Place Rd Se, Cleveland, TN 37323 | 2006-11-30 |
| 1487134482 | Kristy Alese Henegar | Nurse Practitioner | 1420 Fritz St Se, Cleveland, TN 37323 | 2018-08-19 |
| 1417577537 | Eduardo Trevino | Family Medicine | 3009 Midfield Cir Se, Cleveland, TN 37323-0554 | 2020-04-18 |
| 1831339589 | Lyle Foster Johnson | Occupational Therapy Assistant | 2657 Apd 40, Cleveland, TN 37323-0696 | 2009-02-20 |
| Find all providers in zip 37323 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134726987 | Stacy Lynn Reynolds | Counselor | 112 Shade Crest Ln, Cleveland, TX 77327-4343 | 2020-10-05 |
| 1972100196 | April Ballard | Counselor | 14100 Cedar Rd Ste 290, Cleveland, OH 44121-3212 | 2020-10-01 |
| 1952924078 | Chana Rivka Hersh | Counselor | 3762 Bainbridge Rd, Cleveland, OH 44118-2244 | 2020-05-22 |
| 1033739792 | Cassandra Felice Franklin | Counselor | 6629 Worley Ave, Cleveland, OH 44105-3719 | 2020-04-23 |
| 1477189777 | Trauma Recovery and Counseling Services LLC | Counselor | 3886 Rocky River Dr, Cleveland, OH 44111-4119 | 2020-03-18 |
| 1023581758 | Edward Lee Varner | Counselor | 2292 Chambliss Ave Nw Ste C-2, Cleveland, TN 37311-3862 | 2019-01-04 |
| 1093217275 | Carmen Burrows | Counselor | 22001 Fairmount Blvd Bldg K, Cleveland, OH 44118-4819 | 2018-03-05 |
| 1114433570 | Kirstee Williams | Counselor | 1120 North Ocoee Street, Lee University, Cleveland, TN 37311 | 2017-12-21 |
| 1538679139 | Heidi Ables | Counselor | 1225 Wildwood Ave Se, Cleveland, TN 37311-6916 | 2017-10-09 |
| 1679092720 | Megan Davis | Counselor | 1115 Rowley Ave, Cleveland, OH 44109-1843 | 2017-09-10 |
| Find all providers in CLEVELAND | ||||
Please comment or provide details below to improve the information on MR. BRUCE WADE SELVAGE JR..
| 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.