Provider Demographics
NPI:1447339882
Name:WADE, DANNY (LPC)
Entity type:Individual
Prefix:
First Name:DANNY
Middle Name:
Last Name:WADE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 WOODLAND CIR
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-8977
Mailing Address - Country:US
Mailing Address - Phone:830-846-1661
Mailing Address - Fax:830-248-1245
Practice Address - Street 1:121 ROSEWOOD AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-2313
Practice Address - Country:US
Practice Address - Phone:830-249-9977
Practice Address - Fax:830-248-1245
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14632101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional