MR. WADE CHRISTIAN PETERSON MA, LPC, NCC
NPI 1447897806
Counselor - Mental Health in Dallas, TX

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YM0800X and a focus in Mental Health.

Active since December 04, 2019PECOS Enrolled

4144 N CENTRAL EXPY STE 850, DALLAS, TX 75204(972) 865-8782 Get Directions Write a Review

NPPES record last updated: July 24, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jul 24, 2022, Dec 4, 2019 (2 updates tracked since 2019).

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About Mr. Wade Christian Peterson Ma, Lpc, Ncc NPPES

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

MR. WADE CHRISTIAN PETERSON MA, LPC, NCC (NPI 1447897806) is an individual mental health provider in Dallas, Texas, licensed in Texas (80077) and active in the NPI registry since December 2019. He is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1447897806

Entity TypeIndividualMale

Primary Taxonomy101YM0800X

Provider Legal NameMR. WADE CHRISTIAN PETERSONCredential: MA, LPC, NCC

Location Address4144 N CENTRAL EXPY STE 850Dallas, TX 75204-3226

Mailing Address16516 Porterfield LaneFort Worth, TX 76247

Phone(972) 865-8782

Sole ProprietorYes

Medical School CMSOtherGraduated 2017

Enumeration DateDecember 4, 2019

Last NPPES UpdateJuly 24, 20222 updates tracked since enumeration

NPPES CertifiedJuly 24, 2022

✔ NPI 1447897806 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in TX · 80077

4144 N CENTRAL EXPY STE 850, Dallas, TX 75204

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Baylor Scott and White Health Plan, Blue Cross and Blue Shield of Texas, Oscar Insurance Company and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Wade Christian Peterson Ma, Lpc, Ncc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9032691639

PECOS Enrollment IDI20260403000495

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.