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General NPI Number Information
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NPI Number | 1043177850
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Entity Type | Organization
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Legal Business Name | LEIGH WADE LLC
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Dates
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Enumeration Date | 01/06/2026
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 216 W SOUTH ST
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City | FAYETTEVILLE
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State | AR
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Zip | 72701-5959
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Country | US
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Telephone | 479-506-8394
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Fax | 479-755-3580
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Provider Business Mailing Address
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Address Line | 216 W SOUTH ST
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City | FAYETTEVILLE
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State | AR
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Zip | 72701-5959
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Country | US
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Telephone | 479-506-8394
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Fax | 479-755-3580
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Authorized Official
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Title or Position | MENTAL HEALTH THERAPIST
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Name | LEIGH ANNA WADE
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Credential | LCSW
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Telephone | 479-790-3962
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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