Active NPI
Michelle Anne Waide, LCSW
- Clinical Social Worker
- Milwaukee, WI
National Provider Identifier
1467587956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 414123
- Practice address
- 930 E Knapp St
Milwaukee, WI 53202-2896 - Phone
- (414) 276-5432
- NPI assigned
- Feb 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 414123 | WI | Primary |
Addresses
Primary practice location
930 E Knapp St
Milwaukee, WI 53202-2896
Mailing address
930 E Knapp St
Milwaukee, WI 53202-2896
Phone (414) 276-5432
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Aug 25, 2017 through Aug 25, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 414123 | WI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467587956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "930 E KNAPP ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532022896",
"telephone_number": "414-276-5432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "930 E KNAPP ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532022896",
"telephone_number": "414-276-5432"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAIDE",
"first_name": "MICHELLE",
"middle_name": "ANNE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "414123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.