Healthcare Provider Details

I. General information

NPI: 1649994161
Provider Name (Legal Business Name): ASH PATRICK SCHADE MA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2022
Last Update Date: 09/28/2022
Certification Date: 09/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4510 TERRACE AVE
HUNTINGTON WV
25705-1754
US

IV. Provider business mailing address

214 E 8TH ST
PARKERSBURG WV
26101-4615
US

V. Phone/Fax

Practice location:
  • Phone: 304-202-1699
  • Fax:
Mailing address:
  • Phone: 304-917-0021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: