Healthcare Provider Details

I. General information

NPI: 1871217166
Provider Name (Legal Business Name): WADE KERN NETWORK, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2022
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8630 GEORGIA AVE
SILVER SPRING MD
20910-3404
US

IV. Provider business mailing address

4241 BERRY RD
GAINESVILLE VA
20155-1120
US

V. Phone/Fax

Practice location:
  • Phone: 703-239-3660
  • Fax: 703-995-0332
Mailing address:
  • Phone: 703-239-3660
  • Fax: 703-995-0332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: JULIA W DOWNER
Title or Position: OWNER
Credential:
Phone: 703-239-3660