Provider Demographics
NPI:1679958334
Name:MCWADE, JAMIE RENEE (LMHC, IADC)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:RENEE
Last Name:MCWADE
Suffix:
Gender:F
Credentials:LMHC, IADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1912 MIDDLE RD
Mailing Address - Street 2:300B
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-7600
Mailing Address - Country:US
Mailing Address - Phone:563-275-6728
Mailing Address - Fax:563-265-8088
Practice Address - Street 1:1912 MIDDLE RD
Practice Address - Street 2:300B
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-7600
Practice Address - Country:US
Practice Address - Phone:563-275-6728
Practice Address - Fax:563-265-8088
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-23
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001626101YM0800X
IA13040101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)