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General NPI Number Information
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NPI Number | 1043198682
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Entity Type | Organization
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Legal Business Name | LITTLE WINGS COUNSELING LLC
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Dates
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Enumeration Date | 08/22/2025
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 3401 ENTERPRISE PKWY STE 340
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City | BEACHWOOD
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State | OH
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Zip | 44122-7340
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Country | US
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Telephone | 216-630-1010
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Fax |
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Provider Business Mailing Address
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Address Line | 723 EDGEWOOD RD
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City | RICHMOND HEIGHTS
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State | OH
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Zip | 44143-2913
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Country | US
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Telephone | 216-630-1010
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | TYLER MARKUM WADE
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Credential | LPCC-S
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Telephone | 216-630-1010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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