MEDICARE: DANIELLE WADE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	0704015064	VA

General Provider Information

NPI Number	:	1205713377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE WADE

Provider Business Mailing Address
First Line	:	400 S COLORADO BLVD STE 590
Second Line	:
City	:	GLENDALE
State	:	CO
Zip	:	80246-1252
Country	:	US
Telephone Number	:	240-266-0952
Fax Number	:	866-421-4317

Provider Business Practice Location Address
First Line	:	4250 FAIRFAX DR STE 600
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22203-1665
Country	:	US
Telephone Number	:	240-266-0952
Fax Number	:	866-421-4317

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2025
Last Update Date	:	05/27/2026

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Directions to “ DANIELLE WADE ” Practice Location

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