Wataru Okada, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

091169 Issued in NY

Practice address

490 E Ridge Road
Rochester, NY 14621

Phone

(234) 201-0577

NPI assigned

Oct 3, 2016

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1083163000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604 ELMWOOD AVE # 240",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146182213",
            "telephone_number": "234-201-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 E RIDGE ROAD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14621",
            "telephone_number": "234-201-0577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKADA",
        "first_name": "WATARU",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-03",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "091169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS EDUCATION DEPT. OFFICE OF PROFESSIONS",
            "identifier": "091169",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ohle
• Mina Elizabeth Ohm, M.D.
• Lotachukwu Rosemary Ojide, M.D.
• Amole Oloyede Ojo, M.D.
• Sharon Ojo
• Avellina Ihuaku Okafor
• Louis C Okafor, MD
• Ngozi A Okafor
• Patrick Ikemefuna Okolo III, MD MPH
• Ndidiamaka Akudo Okorozo, MD

• All providers in Rochester, NY
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.