Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tyra Wade

Individual provider Mental Health Counselor · NPI 1477735769

Tyra Wade is a Mental Health Counselor in Jackson, Mississippi. Registered with an NPI since 2007.

In the registry since
2007
Specialties on file
2

Practice location Address checks out

4780 I 55 N Ste 105
Jackson, MS 39211-5542
Phone: (601) 956-4816
Fax: (601) 956-4817
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Case Manager/Care Coordinator (primary) Taxonomy 171M00000X
Mental Health Counselor Taxonomy 101YM0800X

Record details

NPI number1477735769
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 29, 2007
Last updated in NPPESMarch 10, 2022
Certification dateMarch 10, 2022
Mailing address4780 I 55 N Ste 105, Jackson, MS 39211-5542

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