Jennifer Wade, PCC-S, LICDC

NPI #1043460256 in Lebanon, Ohio

Provider Information

NPI Number: 1043460256
Entity Type: Individual
Name: Jennifer Wade, PCC-S, LICDC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Professional
Credential: PCC-S, LICDC
Enumeration Date: Sep 24, 2008
Last Updated: Nov 27, 2013

Practice Location

Address: 975 KINGSVIEW DR
City: Lebanon
State: Ohio
ZIP Code: 45036-9562
Phone: (513) 228-7800

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Counselor - Professional — Professional	101YP2500X	Primary

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