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Contact Information

CHADWICK J SHADE, PHD
5955 ZEAMER AVENUE
3RD MDG
ELMENDORF AFB, AK99506
 Phone: 907-580-2181
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for CHADWICK J SHADE · (Male)

NPI # 1255658860
Status Active
Credentials PHD
Entity Individual
Enumeration date 04/23/2010
Last updated 04/23/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • MO License # PSY0091
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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