Active NPI
Macye Wade, MSW, LCSW
- Clinical Social Worker
- Indianapolis, IN
National Provider Identifier
1396127692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34007199A
- Practice address
- 5638 Professional Cir
Indianapolis, IN 46241-5042 - Phone
- (317) 247-8900
- Fax
- (317) 247-8935
- NPI assigned
- Jun 23, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34007199A | IN | Primary |
Addresses
Primary practice location
5638 Professional Cir
Indianapolis, IN 46241-5042
Mailing address
907 Comb Run LN
Avon, IN 46123-9787
Phone (682) 225-4539
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34007199A | IN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436486400000",
"number": "1396127692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "907 COMB RUN LN",
"city": "AVON",
"state": "IN",
"postal_code": "461239787",
"telephone_number": "682-225-4539"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5638 PROFESSIONAL CIR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462415042",
"telephone_number": "317-247-8900",
"fax_number": "317-247-8935"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADE",
"first_name": "MACYE",
"credential": "MSW, LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-23",
"last_updated": "2015-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34007199A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.