Connor Joseph Wade

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC-10044 Issued in ID

Practice address

101 Empty Saddle TRL Ste 120
Hailey, ID 83333-8437

Phone

(208) 928-7507

NPI assigned

Nov 28, 2023

Sex

Male

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

State licenses

Practice roles

Locations

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.

• Carbonate Recovery Center, Inc

  • Addiction (Substance Use Disorder) Counselor
  • Hailey, ID
  • NPI 1225884216
  NPD
• KH Counseling & Health Center, LLC

  • Clinical Social Worker
  • Hailey, ID
  • NPI 1174010573
  NPD

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

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1932975331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 EMPTY SADDLE TRL STE 120",
            "city": "HAILEY",
            "state": "ID",
            "postal_code": "833338437",
            "telephone_number": "208-928-7507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 EMPTY SADDLE TRL STE 120",
            "city": "HAILEY",
            "state": "ID",
            "postal_code": "833338437",
            "telephone_number": "208-928-7507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "CONNOR",
        "middle_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-28",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "LPC-10044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Vanderbeek, LCSW
• Gwendolyn Ann Vandooren, D.C.
• Verst Spine & Orthopedic Care,PLLC
• David Bernard Verst, MD
• Carol A Wade, R.N.,C.S.,F.N.P.
• Benton Wagner
• Britlynn Ward, LAC
• Michelle Ann Watkins, RDH
• Lawrence I Weiner, M.D.
• Whitewater Woodriver Oral Surgery

• Professional Counselor in Hailey, ID
• Providers in Hailey, ID by specialty
• Professional Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; 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.