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NPI Code Detail

MEDICARE: CAMERON WADE RDT, LCASA

MEDICARE: CAMERON WADE RDT, LCASA
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
1101200000XDrama Therapist712
2101YA0400XAddiction (Substance Use Disorder) Counselor30323NC

General Provider Information

NPI Number : 1538746300
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAMERON WADE RDT, LCASA
Provider Business Mailing Address
First Line : 3710 UNIVERSITY DR STE 100
Second Line :
City : DURHAM
State : NC
Zip : 27707-6208
Country : US
Telephone Number : 919-906-4390
Fax Number : 919-287-2707
Provider Business Practice Location Address
First Line : 3710 UNIVERSITY DR STE 100
Second Line :
City : DURHAM
State : NC
Zip : 27707-6208
Country : US
Telephone Number : 919-906-4390
Fax Number : 919-287-2707
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2021
Last Update Date : 07/31/2025

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Directions to “ CAMERON WADE RDT, LCASA” Practice Location

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