Mr Mark Harrison Wade, LPC CSAC is a
Social Worker - Clinical based in Big Stone Gap, Virginia. Mr Mark Harrison Wade is licensed to practice in Virginia (license number 0710102025) and his current practice location is
3169 2nd Ave E, Big Stone Gap, Virginia. He can be reached at his office (for appointments etc.) via phone at
(276) 523-8300.
NPI number for Mr Mark Harrison Wade is 1104964097 and his current mailing address is Po Box 9054, Gray, Tennessee. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1104964097.
Healthcare Provider's Profile
| Full Name | Mr Mark Harrison Wade |
|---|
| Gender | Male |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | 3169 2nd Ave E, Big Stone Gap, Virginia |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1104964097
- Provider Enumeration Date: 02/02/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Mr Mark Harrison Wade such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1104964097 | NPI | - | NPPES |
| 0101499914 | Medicaid | VA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YP2500X | Counselor - Professional | 0701003573 (Virginia) | Primary |
| 1041C0700X | Social Worker - Clinical | 0710102025 (Virginia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Mark Harrison Wade is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Mark Harrison Wade, LPC CSAC
Po Box 9054,
Gray, TN 37615-9054
Ph: (423) 467-3600 | Mr Mark Harrison Wade, LPC CSAC
3169 2nd Ave E,
Big Stone Gap, VA 24219
Ph: (276) 523-8300 |
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