MEDICARE: JADEE LLC DBA DONNA WADE LPC, LADC

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

General Provider Information

NPI Number	:	1457288359
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JADEE LLC DBA DONNA WADE LPC, LADC

Provider Business Mailing Address
First Line	:	616 NW 40TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118-7044
Country	:	US
Telephone Number	:	405-659-5329
Fax Number	:

Provider Business Practice Location Address
First Line	:	901 NW 63RD ST STE 104
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73116-7622
Country	:	US
Telephone Number	:	405-659-5329
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DONNA WADE
Credential	:	LPC, LADC
Telephone Number	:	405-659-5329

Provider Enumeration Date	:	05/05/2026
Last Update Date	:	05/05/2026

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