Amanda J Wade, M.A.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

0757 Issued in KY

Practice address

1215 High St
Bowling Green, KY 42101-2541

Phone

(270) 782-1116

Fax

(270) 782-9108

NPI assigned

Jan 3, 2007

Sex

Female

Sole proprietor

No

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.

• Chestnut Park Professionals, LLC

  • Psychologist
  • Bowling Green, KY
  • NPI 1265574396
  NPD (past) PSYCHOLOGIST

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720145279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 HIGH ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421012541",
            "telephone_number": "270-782-1116",
            "fax_number": "270-782-9108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 HIGH ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421012541",
            "telephone_number": "270-782-1116",
            "fax_number": "270-782-9108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "AMANDA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KY",
            "license": "0757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Eric Voakes, M.D.
• Thomas Vogler, APRN
• Corrie J. Vos, PH.D.
• Judith A Waddell, ARNP
• Renee S. Waddell
• Karen Wade
• Megan Nicole Wade, CSW
• Jeremy Michael Wagoner, LCSW
• Danielle Waild, MSW, LCSW
• Wal-Mart Stores East LP

• All providers in Bowling Green, KY
• Psychologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.