Alicia Wade

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

149019700 Issued in IL

Practice address

420 W Grand Ave
Lake Villa, IL 60031

Phone

(847) 356-3322

NPI assigned

Dec 26, 2017

Last updated

Dec 26, 2017By the provider in NPPES

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)

Enrolled

State licenses

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

{
    "created_epoch": "1514246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514246400000",
    "number": "1750897997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1088",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "600461088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W GRAND AVE",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "60031",
            "telephone_number": "847-356-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "ALICIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-26",
        "last_updated": "2017-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "149019700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Thompson, SLP
• Tiana Lynn Torres, D.C.
• Anfernee Tran, PT, DPT
• Gail Truger
• Sandra Lee Reinke Venden, PSYD
• Walgreen Co (Walgreens #05108)
• Jasmine Ward
• Suzan A Washington, PH.D.
• Jennifer Weber, PT
• Lorraine Weber, LCSW

• Mental Health Counselor in Lake Villa, IL
• Providers in Lake Villa, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2017; 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.