Jessica Waller Wade
Individual provider Active NPI Social Worker · Marshalls Creek, PA
NPI 1831775006 · NPPES record last updated Mar 19, 2021
Key facts
- NPI
- 1831775006
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- SW134964 (PA)
- Practice address
- 317 Dartmouth Drive, BLDG 4, Unit 3
Marshalls Creek, PA 18335 - Phone
- (570) 730-4211
- NPI assigned
- Mar 19, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW134964 | PA | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | SW134964 | PA | Yes |
Addresses
Primary practice location
317 Dartmouth Drive, BLDG 4, Unit 3
Marshalls Creek, PA 18335
Mailing address
317 Dartmouth Drive, BLDG 4, Unit 3
Marshalls Creek, PA 18335
Phone (570) 730-4211
Other providers in Marshalls Creek, PA
- Hellstrom Consulting Inc
- Matthew Vincent Hooper
- Michael A. Hunt
- Michael a. Hunt DDS, Family Dentistry
- SJB Diagnostic Screening LLC
All providers in Marshalls Creek, PA · Social Worker in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.