Gail a. Shade, M.a., LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1001 Issued in WV

Legal business name

GAIL A. SHADE, M.A., LLC

Practice address

640 Fairfax St
Suite #3
Berkeley Springs, WV 25411-1622

Phone

(304) 258-5353

Fax

(304) 258-9313

NPI assigned

Dec 28, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Gail Arlene Shade, BSW, MA. PSYDNPI 1912084385

Title

Licensed Professional Counselor

Phone

(304) 258-5353

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gail Arlene Shade, LPC

  • Professional Counselor
  • Berkeley Springs, WV
  • NPI 1912084385
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609932623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 903",
            "city": "BERKELEY SPRINGS",
            "state": "WV",
            "postal_code": "254110903",
            "telephone_number": "304-258-5353",
            "fax_number": "304-258-9313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 FAIRFAX ST",
            "address_2": "SUITE #3",
            "city": "BERKELEY SPRINGS",
            "state": "WV",
            "postal_code": "254111622",
            "telephone_number": "304-258-5353",
            "fax_number": "304-258-9313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAIL A. SHADE, M.A., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHADE",
        "authorized_official_first_name": "GAIL",
        "authorized_official_middle_name": "ARLENE",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "304-258-5353",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BSW, MA. PSYD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "WV",
            "license": "1001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Freeland, DO
• Christina Margaret Freels, LICSW
• Carol Froebe
• Dawn Fry
• Kelcee Fulton
• Jenelle Paige Galusic
• Evelyn Garcia
• Lisa Garcia, SURGICAL ASSISTANT
• Antoinette Gatto
• Vilma Geist

• Professional Counselor in Berkeley Springs, WV
• Providers in Berkeley Springs, WV by specialty
• Professional Counselor in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.