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Organization
WISTERIA COUNSELING
Active
Organization
WISTERIA COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE WADE MA, LPC (OWNER)
(267) 386-5432
Entity
Organization
Contact information
Practice address
121 N MAIN ST STE 310, SOUDERTON, PA 18964-1799
(267) 354-0113
Mailing address
121 N MAIN ST STE 310, SOUDERTON, PA 18964-1799
(267) 354-0113
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
03/13/2023
Last updated
03/13/2023
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