Provider Demographics
NPI:1679944979
Name:WADE, HARRIETTE RAYSHEEN (MS, LPC)
Entity type:Individual
Prefix:
First Name:HARRIETTE
Middle Name:RAYSHEEN
Last Name:WADE
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Gender:F
Credentials:MS, LPC
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Other - Middle Name:
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Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-743-2445
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:1112 E ASCENSION COMPLEX BLVD
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-4265
Practice Address - Country:US
Practice Address - Phone:225-743-2445
Practice Address - Fax:225-450-1150
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA5750101YP2500X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional