Provider Demographics
NPI:1427659630
Name:WADE, SHERRIE (LMHC 3015)
Entity type:Individual
Prefix:MRS
First Name:SHERRIE
Middle Name:
Last Name:WADE
Suffix:
Gender:F
Credentials:LMHC 3015
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 NE WAVECREST WAY
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-4220
Mailing Address - Country:US
Mailing Address - Phone:561-479-6132
Mailing Address - Fax:954-252-4044
Practice Address - Street 1:260 NE WAVECREST WAY
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-4220
Practice Address - Country:US
Practice Address - Phone:561-479-6132
Practice Address - Fax:954-252-4044
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3015101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health