MR. Jonathan Lewis Wade SR., M.DIV.

NPI #1366795890 in Brookhaven, Pennsylvania

Provider Information

NPI Number: 1366795890
Entity Type: Individual
Name: MR. Jonathan Lewis Wade SR., M.DIV.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Addiction (Substance Use Disorder)
Credential: M.DIV.
Enumeration Date: Oct 22, 2012
Last Updated: Oct 22, 2012

Practice Location

Address: 5000 HILLTOP DR
City: Brookhaven
State: Pennsylvania
ZIP Code: 19015-1228
Phone: (484) 490-1060

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X	Primary
Counselor - Mental Health — Mental Health	101YM0800X
Counselor - Pastoral — Pastoral	101YP1600X

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