MEDICARE: SERENA LEE 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

General Provider Information

NPI Number	:	1871284786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SERENA LEE WADE

Provider Business Mailing Address
First Line	:	1600 CORNELL ST
Second Line	:
City	:	MCKEESPORT
State	:	PA
Zip	:	15132-4613
Country	:	US
Telephone Number	:	412-660-5027
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 HOT METAL ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15203-2348
Country	:	US
Telephone Number	:	412-660-5027
Fax Number	:

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

Provider Enumeration Date	:	05/19/2023
Last Update Date	:	05/26/2026

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