Active NPI
Nathan Tucker Wade
- Professional Counselor
- Memphis, TN
National Provider Identifier
1023708138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6004
- Practice address
- 6363 Poplar Ave Ste 404
Memphis, TN 38119-4831 - Phone
- (901) 626-3403
- NPI assigned
- May 11, 2023
- 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 | 6004 | TN | Primary |
Addresses
Primary practice location
6363 Poplar Ave Ste 404
Memphis, TN 38119-4831
Mailing address
4655 Doris Cir S
Millington, TN 38053-2301
Phone (901) 626-3403
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 |
|---|---|---|---|
| 6004 | TN | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758585600000",
"number": "1023708138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4655 DORIS CIR S",
"city": "MILLINGTON",
"state": "TN",
"postal_code": "380532301",
"telephone_number": "901-626-3403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6363 POPLAR AVE STE 404",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381194831",
"telephone_number": "901-626-3403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADE",
"first_name": "NATHAN",
"middle_name": "TUCKER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-05-11",
"last_updated": "2025-09-23",
"certification_date": "2025-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TN",
"license": "6004",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.