W Wade PHD LP LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

LP5259 Issued in MN

Legal business name

W WADE PHD LP LLC

Practice address

4500 Park Glen Rd
Suite 270
St Louis Park, MN 55416-4871

Phone

(952) 929-9478

Fax

(952) 929-9548

NPI assigned

Feb 1, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Wendy Ann Wade, PHD LP

Title

Owner

Phone

(612) 385-6392

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1296518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296518400000",
    "number": "1477859940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 PARK GLEN RD",
            "address_2": "SUITE 270",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164871",
            "telephone_number": "952-929-9478",
            "fax_number": "952-929-9548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 PARK GLEN RD",
            "address_2": "SUITE 270",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164871",
            "telephone_number": "952-929-9478",
            "fax_number": "952-929-9548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W WADE PHD LP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-01",
        "last_updated": "2011-02-01",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-385-6392",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD LP"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "MN",
            "license": "LP5259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Gardiner Voss
• Jonathan Douglas Voss, MD
• Heather Christine Votava-Bialczyk, MD
• Julian Vrudny
• Robin Katherine Vu, DPT
• Wendy Ann Wade, PHD
• Punit D Wadhwa, MD
• Jessica G Wageman, PA-C
• David Bryan Waggonner, M.D.
• Kathy Wagle, APRN, CNS

• Adult Mental Health Clinic/Center in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Adult Mental Health Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2011; 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.