Kevin Wade, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

14805 Issued in MD

Practice address

200 E North Ave
Baltimore, MD 21202-4888

Phone

(410) 396-0774

NPI assigned

May 17, 2019

Last updated

May 17, 2019By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1558051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558051200000",
    "number": "1174189922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E NORTH AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212025984",
            "telephone_number": "410-396-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E NORTH AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212024888",
            "telephone_number": "410-396-0774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "737 Old Westminster Pike",
            "address_purpose": "LOCATION",
            "city": "Westminster",
            "state": "MD",
            "postal_code": "211576227",
            "country_code": "US",
            "telephone_number": "443-487-7107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WADE",
        "first_name": "KEVIN",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-17",
        "last_updated": "2019-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "14805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Wade
• Brenda Carleen Wade
• Carol R Wade, CRNP
• Dexter Antonio Wade, MS, CAC-AD
• Heather Larkin Wade, M.D.
• Mariah Wade
• Michael Wade, LCSW-C
• Sydney Ashleigh Wade, MPH
• Akhilesh Wadhwa, M.D.
• Sonal Desai Wadhwa, M.D.

• Clinical Social Worker in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2019; 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.