Individual
MR. WESLEY JACKSON WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NCC, CCMHC, LCAS-A
Contact information
Practice address
227 MAINLINE STATION DR, MORRISVILLE, NC 27560-6112
(919) 530-9446
Mailing address
107 WINDEL DR STE 207A, RALEIGH, NC 27609-4471
(919) 530-9446
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-23410
NC
Other
Enumeration date
02/27/2017
Last updated
02/27/2017
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