Jennifer R Wade, M.ED., BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

0133000139 Issued in VA

Practice address

4501 Tall Hickory Dr
Midlothian, VA 23112-4805

Phone

(804) 539-9987

NPI assigned

Jan 2, 2013

Last updated

Jan 2, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Beyond Behavior Consulting

  • Behavior Analyst
  • Midlothian, VA
  • NPI 1881930303
  NPD (past) Authorized official

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

{
    "created_epoch": "1357084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357084800000",
    "number": "1326384843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 TALL HICKORY DR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231124805",
            "telephone_number": "804-539-9987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 TALL HICKORY DR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231124805",
            "telephone_number": "804-539-9987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "JENNIFER",
        "middle_name": "R",
        "credential": "M.ED., BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-02",
        "last_updated": "2013-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0133000139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Aku Vordjorbe
• Voyage Behavioral Health, LLC
• Samuel Waagen, PT
• Kirsten Elizabeth Wachsmann
• Dustin Wade, LPN, BSHA, CPHQ
• Margaret Anne Wade, M.ED. CCC-SLP
• Christina Michele Wagner, MD
• Glenda Abbieann Wagner
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1969)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2808)

• Behavior Analyst in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2013; 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.