Mary Tate Thomas Wade, ALC, MA

Primary specialty

CounselorTaxonomy code 101Y00000X

License

ALC04259 Issued in AL

Practice address

400 Office Park Dr
Mountain BRK, AL 35223-3408

Phone

(205) 730-6217

NPI assigned

Oct 3, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Mary Tate Wade Counseling LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mountain BRK, AL
  • NPI 1790476638
  NPD Authorized official

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

{
    "created_epoch": "1664755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1689398695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604 DENYSE DR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352434101",
            "telephone_number": "205-862-2603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 OFFICE PARK DR",
            "city": "MOUNTAIN BRK",
            "state": "AL",
            "postal_code": "352233408",
            "telephone_number": "205-730-6217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "MARY",
        "middle_name": "TATE THOMAS",
        "credential": "ALC, MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-03",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AL",
            "license": "ALC04259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maegan Renee Vick, LPC
• Visionsouth PC
• Vulcan Performance Mountain Brook, LLC
• Vulcan Performance Rehabilitation and Recovery LLC
• Christina Jones Wade, LMT
• Stephen Wade, LMT
• Talia Waitkus, LCSW BCBA
• Nancy Walburn, LPC
• Kendall Waldrop, MS, RDN, LD
• Walgreen Co

• Counselor in Mountain BRK, AL
• Providers in Mountain BRK, AL by specialty
• Counselor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; 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.