K Osiris Wade, LPC-S, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

63200 Issued in TX

Practice address

2770 Main St Ste 243
Frisco, TX 75033-4477

Phone

(720) 446-8696

Fax

(972) 704-3629

NPI assigned

Apr 5, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Deep Eddy Psychotherapy Management, LLCGroup PAC ID 2264886936, 70 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Deep Eddy Psychotherapy Management, LLC

  • Counseling Psychologist
  • Austin, TX
  • NPI 1457740862
  Medicare reassignment Care Compare group NPD
• Wade Counseling of Frisco, PLLC

  • Mental Health Counselor
  • Frisco, TX
  • NPI 1720556186
  NPD Authorized official
• Deep Centered Psychiatry PLLC

  • Psychiatry Physician
  • Austin, TX
  • NPI 1629853825
  NPD (past)

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

{
    "created_epoch": "1270425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1508181322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2770 MAIN ST STE 243",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750334477",
            "telephone_number": "720-446-8696",
            "fax_number": "972-704-3629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2770 MAIN ST STE 243",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750334477",
            "telephone_number": "720-446-8696",
            "fax_number": "972-704-3629"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4514 Cole Ave Ste 631",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752055412",
            "country_code": "US",
            "telephone_number": "469-574-6000",
            "fax_number": "469-574-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WADE",
        "first_name": "K OSIRIS",
        "credential": "LPC-S, NCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-05",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "63200",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "63200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josephine Nchangnwie Vuchansu
• Sowmya Vulpala
• Anitha Vyza, MD
• Randell Blake Waddell, LMT
• Wade Counseling of Frisco, PLLC
• Leah Wade, RN BSN
• Rhonda Wade
• Shelby Wade
• Traci Jill Wade, D.D.S.
• Gabrielle Kayobyo Wagabaza, DC

• Mental Health Counselor in Frisco, TX
• Providers in Frisco, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.