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Individual
LARISA WADE
Active
Individual
LARISA WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LH61361392
WA
101YP2500X
Professional Counselor
18906
CA
101YP2500X
Professional Counselor
BBH-LCPC-LIC-81060
MT
101YP2500X
Professional Counselor
LPC.0020639
CO
Other
Enumeration date
07/02/2020
Last updated
09/25/2025
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