Individual
MR. BRIAN WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.C.S.W
Contact information
Practice address
283 COMMACK RD, SUITE 125, COMMACK, NY 11725-6021
(631) 421-2547
(631) 421-2547
Mailing address
39 E 16TH ST, HUNTINGTON STATION, NY 11746-2931
(631) 271-7226
(631) 421-2547
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
R037491-1
NY
Other
Enumeration date
12/05/2006
Last updated
07/08/2007
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