Active NPI
Wesley Jackson Wade, NCC, CCMHC, LCAS-A
- Addiction (Substance Use Disorder) Counselor
- Morrisville, NC
National Provider Identifier
1457891236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- LCAS-23410
- Practice address
- 227 Mainline Station Dr
Morrisville, NC 27560-6112 - Phone
- (919) 530-9446
- NPI assigned
- Feb 27, 2017
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LCAS-23410 | NC | Primary |
Addresses
Primary practice location
227 Mainline Station Dr
Morrisville, NC 27560-6112
Mailing address
107 Windel Dr Ste 207a
Raleigh, NC 27609-4471
Phone (919) 530-9446
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 |
|---|---|---|---|
| LCAS-23410 | NC | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488153600000",
"number": "1457891236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 WINDEL DR STE 207A",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276094471",
"telephone_number": "919-530-9446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "227 MAINLINE STATION DR",
"city": "MORRISVILLE",
"state": "NC",
"postal_code": "275606112",
"telephone_number": "919-530-9446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADE",
"first_name": "WESLEY",
"middle_name": "JACKSON",
"name_prefix": "Mr.",
"credential": "NCC, CCMHC, LCAS-A",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-02-27",
"last_updated": "2017-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "LCAS-23410",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morrisville, NC
- Hymavathi Venati, RPH
- Simone Venning, AGNP
- Vigilint Expeditionary Solutions
- Vigilint Protective Health Solutions, PLLC
- Vip Care Transportation LLC
- Heather Devault Wagner
- Derek Wahl, PA-C
- Wake Med Children's PM Pediatric Urgent Care
- Wake Specialty Physicians (WSP Morrisville Primary Care)
- Wake Specialty Physicians LLC (WakeMed MyCare 365 Primary & Urgent Care Morrisville)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.