Jonathan Lewis Wade Sr., M.DIV.

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

5000 Hilltop Dr
Brookhaven, PA 19015-1228

Phone

(484) 490-1060

Fax

(610) 876-4534

NPI assigned

Oct 22, 2012

Sex

Male

Sole proprietor

No

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

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

{
    "created_epoch": "1350864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1366795890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 BLACKWOOD CLEMENTON RD",
            "address_2": "APT. 1901",
            "city": "LINDENWOLD",
            "state": "NJ",
            "postal_code": "080216878",
            "telephone_number": "609-562-3992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 HILLTOP DR",
            "city": "BROOKHAVEN",
            "state": "PA",
            "postal_code": "190151228",
            "telephone_number": "484-490-1060",
            "fax_number": "610-876-4534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "JONATHAN",
        "middle_name": "LEWIS",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "M.DIV.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-22",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fariha Ummi, RPH
• Julie Kaye Vadino, LCSW
• Maria Isabel Valentin
• Marijke Vanleeuwen, DPT
• Erica Volpe
• Walgreen Eastern Co Inc
• Walkermovementgroup LLC
• Lashirah Warren Glenn, MSW, LSW
• Demonso Waters
• David Watkins

• Addiction (Substance Use Disorder) Counselor in Brookhaven, PA
• Providers in Brookhaven, PA by specialty
• Addiction (Substance Use Disorder) Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; 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.