Individual provider Active NPI

Jessica Wade

  • Mental Health Counselor
  • Northbrook, IL
National Provider Identifier
1881233260
Registry record updated Mar 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
5 Revere Dr Ste 120
Northbrook, IL 60062-8005
Phone
(847) 306-9843
NPI assigned
Jan 2, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

5 Revere Dr Ste 120
Northbrook, IL 60062-8005

Mailing address

8490 E Crescent Pkwy Ste 200
Greenwood Village, CO 80111-2802
Phone (720) 441-4690

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1577923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743292800000",
    "number": "1881233260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8490 E CRESCENT PKWY STE 200",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801112802",
            "telephone_number": "720-441-4690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 REVERE DR STE 120",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600628005",
            "telephone_number": "847-306-9843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-02",
        "last_updated": "2025-03-30",
        "certification_date": "2025-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2025; 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.