Harry Kevin Wade, LPC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2020003709 Issued in MO

Practice address

3897 N 20TH St Ste 1
Ozark, MO 65721-8522

Phone

(417) 770-2901

NPI assigned

Jul 22, 2019

Last updated

Feb 8, 2024By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1619520368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3897 N 20TH ST STE 1",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "657218522",
            "telephone_number": "417-770-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3897 N 20TH ST STE 1",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "657218522",
            "telephone_number": "417-770-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "HARRY",
        "middle_name": "KEVIN",
        "credential": "LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-22",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2020003709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Ozark, MO
• Providers in Ozark, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; 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.