Healthcare Provider Details

I. General information

NPI: 1457288359
Provider Name (Legal Business Name): JADEE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 NW 63RD ST STE 104
OKLAHOMA CITY OK
73116-7622
US

IV. Provider business mailing address

616 NW 40TH ST
OKLAHOMA CITY OK
73118-7044
US

V. Phone/Fax

Practice location:
  • Phone: 405-659-5329
  • Fax:
Mailing address:
  • Phone: 405-659-5329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DONNA WADE
Title or Position: OWNER
Credential: LPC, LADC
Phone: 405-659-5329