Michelle Dominique Wade, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

106104 Issued in NY

Practice address

257 Main St
New Paltz, NY 12561-1610

Phone

(845) 532-6064

NPI assigned

Aug 17, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Michelle Wade

  • Adult Mental Health Clinic/Center
  • Newburgh, NY
  • NPI 1396448940
  Authorized official Same address or phone
• Doree Lipson, LCSW PC

  • Clinical Social Worker
  • New Paltz, NY
  • NPI 1659767192
  NPD
• T Grant PHD

  • Clinical Psychologist
  • New Paltz, NY
  • NPI 1215211719
  NPD

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

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1518633932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 MAIN ST",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125611610",
            "telephone_number": "845-419-1563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 MAIN ST",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125611610",
            "telephone_number": "845-532-6064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "MICHELLE",
        "middle_name": "DOMINIQUE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-17",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "106104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "SimplePractice",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "257 Main St",
            "city": "New Paltz",
            "state": "NY",
            "country_code": "US",
            "postal_code": "125611610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lisa Urrico, MHC-LP
• Susan Patricia Van de Bogart, PT
• Sarah E Venza
• Eric Romeo Verruto, O.D.
• Vincent a Justino DC PC (Justino Chiropractic and Wellness Center)
• Walgreen Co (Walgreens #17317)
• Ashley Walko, LMHC
• Stephen Jay Walko II, LMHC
• Rebecca Walters, LCAT LMHC
• Joette Warren, PH.D.

• Clinical Social Worker in New Paltz, NY
• Providers in New Paltz, 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 Mar 23, 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.