JENNIFER WADE COUNSELOR INTERN
NPI 1356053409
Counselor - Mental Health in Moscow, ID

Q: What is Jennifer Wade's NPI number?

The NPI number for Jennifer Wade is 1356053409. It was assigned to this individual provider in the NPPES registry on December 20, 2022.

Q: What is Jennifer Wade's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Jennifer Wade was last updated on December 20, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since December 20, 2022PECOS EnrolledAccepts Medicare Assignment

317 W 6TH ST STE 208, MOSCOW, ID 83843(208) 882-3504 Get Directions Write a Review

NPPES record last updated: December 20, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Jennifer Wade Counselor Intern NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JENNIFER WADE COUNSELOR INTERN (NPI 1356053409) is an individual mental health provider in Moscow, Idaho and active in the NPI registry since December 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1356053409

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameJENNIFER WADECredential: COUNSELOR INTERN

Location Address317 W 6TH ST STE 208Moscow, ID 83843-2387

Mailing Address421 E 6th St Apt 3Moscow, ID 83843-2954 · (713) 419-5888

Phone(208) 882-3504

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateDecember 20, 2022

NPPES CertifiedDecember 20, 2022

✔ NPI 1356053409 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

317 W 6TH ST STE 208, Moscow, ID 83843

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jennifer Wade Counselor Intern is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9830531318

PECOS Enrollment IDI20240529003457

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. RACHAEL ANNA KIMBLE LMSW

Counselor (Mental Health)