| Organization Name: | GAIL A. SHADE, M.A., LLC |
| NPI Number: | 1609932623 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GAIL ARLENE SHADE (LICENSED PROFESSIONAL COUNSELOR) |
| Mailing Address: | 640 Fairfax St Suite #3 Berkeley Springs |
| State: | WV US |
| Postal Code: | 254111622 |
| Phone Number: | 3042585353 |
| Fax Number: | 3042589313 |
| NPI Enumeration Date: | 12/28/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 1001 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |