Laurie Jean Wade

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

058408 Issued in NY

Practice address

11 Haswell Rd
Watervliet, NY 12189-1302

Phone

(518) 273-4911

NPI assigned

May 10, 2019

Sex

Female

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St. Colman'S Home Inc.

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Watervliet, NY
  • NPI 1144351339
  NPD (past)

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

{
    "created_epoch": "1557446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557446400000",
    "number": "1194381657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 HASWELL RD",
            "city": "WATERVLIET",
            "state": "NY",
            "postal_code": "121891302",
            "telephone_number": "518-273-4911",
            "fax_number": "518-273-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 HASWELL RD",
            "city": "WATERVLIET",
            "state": "NY",
            "postal_code": "121891302",
            "telephone_number": "518-273-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "LAURIE",
        "middle_name": "JEAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-10",
        "last_updated": "2019-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "058408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• U.S Petro Inc
• Renee Vincent, LPN
• Haani Mohammed Shakil Virjee, DDS
• Shakil Ali Virjee, D.M.D.
• Leonid Vovna, PHARM. D.
• Walgreen Co
• Watervliet City School District
• Watervliet Pharmacy Acquisition, LLC
• Watervliet Pharmacy Acquisition, LLC
• Whitney M Young Jr. Health Center, Inc

• Clinical Social Worker in Watervliet, NY
• Providers in Watervliet, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.