Active NPI
Paul Wade, PSYD
- Professional Counselor
- Columbia, SC
National Provider Identifier
1013432004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6450
- Practice address
- 1107 Belleview St
Columbia, SC 29201-1810 - Phone
- (803) 445-5211
- NPI assigned
- Aug 10, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6450 | SC | Primary |
Addresses
Primary practice location
1107 Belleview St
Columbia, SC 29201-1810
Mailing address
344 Clearview Dr
Columbia, SC 29212-8310
Phone (803) 445-5211
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6450 | SC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502323200000",
"number": "1013432004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "344 CLEARVIEW DR",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292128310",
"telephone_number": "803-445-5211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1107 BELLEVIEW ST",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292011810",
"telephone_number": "803-445-5211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADE",
"first_name": "PAUL",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-08-10",
"last_updated": "2017-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "SC",
"license": "6450",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.