Eddia Marie McDade, PHD, PMHNP, RN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4704177892 Issued in MI

Practice address

1025 Huron Ave FL 2
Port Huron, MI 48060-3763

Phone

(810) 966-6025

Fax

(810) 622-3598

NPI assigned

Jul 23, 2015

Sex

Female

Sole proprietor

Yes

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

Credentials

Nurse Practitioner, Doctor of Philosophy, Registered Nurse

State licenses

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

{
    "created_epoch": "1437609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1942685607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 HURON AVE FL 2",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603763",
            "telephone_number": "810-966-6025",
            "fax_number": "810-622-3598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 HURON AVE FL 2",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603763",
            "telephone_number": "810-966-6025",
            "fax_number": "810-622-3598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDADE",
        "first_name": "EDDIA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHD, PMHNP, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-23",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704177892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracie McClarty, LPN
• Rebekah Jeanne McClearen
• Alexandria Mae McCracken, LLMSW
• John C McCue, CRNA
• Jonathan Peter McCulloch, LLMSW
• Erin Michelle McDaid, LMSW
• Bradley J McDonald, LMSW
• Homeira McDonald, MD
• Kaitlyn McDonald, LLMSW
• Mary T McDonald

• Psychiatric/Mental Health Nurse Practitioner in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.