Fedena C Wade, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904016859 Issued in VA

Practice address

1115 Franklin Tpke Ste 10
Danville, VA 24540-1362

Phone

(804) 930-4720

NPI assigned

May 18, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• True Potential Therapy PLLC

  • Community/Behavioral Health Agency
  • Danville, VA
  • NPI 1699516963
  NPD Authorized official
• Face Forward Behavioral Health Services LLC

  • Community/Behavioral Health Agency
  • Danville, VA
  • NPI 1013874460
  NPD
• Full Circle Behavioral LLC

  • Community/Behavioral Health Agency
  • Danville, VA
  • NPI 1831764034
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1715990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715990400000",
    "number": "1114776309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2083",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238041383",
            "telephone_number": "804-930-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 FRANKLIN TPKE STE 10",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245401362",
            "telephone_number": "804-930-4720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "FEDENA",
        "middle_name": "C",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-18",
        "last_updated": "2024-05-18",
        "certification_date": "2024-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0904016859",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "VA",
            "license": "0904016859",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904016859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kurt Voos, MD
• VSP Dental Inc.
• W. Berry Maultsby, Jr., O.D., P.C.
• W. William Wentz, Jr., DDS, PC & Herbert C. Manry, DDS, PC
• Marilyn Wade-Foster, NP-C
• George L Wade Jr., PA
• Wal-Mart Stores East LP
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Alexandra Kay Walcott, MS, OTR/L

• Clinical Social Worker in Danville, VA
• Providers in Danville, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.