Carla Jo Wade, LCAC,LMLP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

10848 Issued in KS

Practice address

3820 N Toben St
Wichita, KS 67226-2903

Phone

(316) 634-3954

Fax

(316) 634-3956

NPI assigned

Jan 10, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Carla Jo Witter Lawrence Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• The Mirror, Inc.

  • Substance Abuse Rehabilitation Facility
  • Newton, KS
  • NPI 1053431676
  NPD

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

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1205597416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 E 5TH ST",
            "city": "NEWTON",
            "state": "KS",
            "postal_code": "671142206",
            "telephone_number": "316-283-6743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 N TOBEN ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672262903",
            "telephone_number": "316-634-3954",
            "fax_number": "316-634-3956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "CARLA",
        "middle_name": "JO",
        "credential": "LCAC,LMLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-10",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "953",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "247",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "10848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLA",
            "last_name": "WITTER LAWRENCE",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• W H Whiteside Inc
• W.R. Whitlow, D.D.S., PA
• Wacs Inc
• Anna Waddell
• Bryanna Waddell, APRN
• Carmen Wade, RPH
• Clara Ann Wade
• Edward Wade, MD
• Laurinda Wade, CRNA
• Paul David Wade, RPH

• Addiction (Substance Use Disorder) Counselor in Wichita, KS
• Providers in Wichita, KS by specialty
• Addiction (Substance Use Disorder) Counselor in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; 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.