DR. PRISCILLA WADE

Address: 411 W Lake Lansing Rd, Suite C-125, East Lansing, MI 48823-8445
Phone: 5173367366

DR. PRISCILLA WADE (NPI# 1871650291) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1871650291
Entity Type 1 - Individual
Full Name DR. PRISCILLA WADE
Credential PH.D
Practice Address 411 W Lake Lansing Rd
Suite C-125
East Lansing
MI 48823-8445
Mailing Address Po Box 4455
East Lansing
MI 48826-4455
Practice Telephone 5173367366
Practice Fax Number 5173360808
Enumeration Date 01/03/2007
Last Update Date 07/08/2007
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103T00000X Psychologist 6301007011 MI Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
MI BLUE CROSS TRUST 11291411 01
MI BLUE CROSS BLUE SHIELD 68OC34678 01
MI MAGELLAN R67036 01
MI BLUE CARE NETWORK MI5228936 01
MI CONNECTICUT GENERAL 78357 01
MI VALUE OPTIONS 03626 01
MI CONNECTICUT GENERAL 063276 01
MI MCLAREN 1016708 01
MI GENERAL MOTORS 063276 01
MI VENDOR NUMBER A029412 01

Office Location

Street Address 411 W LAKE LANSING RD
SUITE C-125
City EAST LANSING
State MI
Zip Code 48823-8445

Providers with the same location

NPI Name Address
1528023454 DR. JEFFREY HAROLD LIMONOFF 411 W Lake Lansing Rd, Ste A105, East Lansing, MI 48823-8445
1376509455 DR. ROBIN LOWELL BARRICKLOW 411 W Lake Lansing Rd, Suite A-105, East Lansing, MI 48823-8445
1407910854 PSYCHOLOGICAL AND CONSULTATION SERVICES PC 411 W Lake Lansing Rd, Suite C-125, East Lansing, MI 48823-8445
1891842001 DR. JENNIFER SMITH ALLSWEDE 411 W Lake Lansing Rd, East Lansing, MI 48823-8445
1851502389 LIMONOFF CHIROPRACTIC CLINICS INC. 411 W Lake Lansing Rd, Ste A105, East Lansing, MI 48823-8445
1457594947 JOSH EDWARD THORNHILL 411 W Lake Lansing Rd, Suite C120, East Lansing, MI 48823-8445
1114232238 DR. ANTHONY SANFORD BURGESS 411 W Lake Lansing Rd, Suite C 120, East Lansing, MI 48823-8445
1740565704 MELANI ANN REAUME 411 W Lake Lansing Rd, Suite C 120, East Lansing, MI 48823-8445
1295094035 KERI LOUISE STURDEVANT 411 W Lake Lansing Rd, Suite C 120, East Lansing, MI 48823-8445
1952779571 AMY NOSTRANT 411 W Lake Lansing Rd, Ste C - 120, East Lansing, MI 48823-8445

Competitor

Search similar physicians

City EAST LANSING
Zip Code 48823

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.