Wade Patrick Mackey, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

64697 Issued in TX

Practice address

1030 E Live Oak St
Waco, TX 76704-2258

Phone

(254) 741-4924

NPI assigned

Sep 25, 2023

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

Opted out of Medicare

Yes, effective Sep 18, 2024 through Sep 18, 2026

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.

• Compleo Physical Therapy & Wellness LLC

  • Physical Therapist
  • Woodway, TX
  • NPI 1902338395
  NPD (past)

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1548049067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 FORT AVE",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767105216",
            "telephone_number": "903-752-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 E LIVE OAK ST",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767042258",
            "telephone_number": "254-741-4924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKEY",
        "first_name": "WADE",
        "middle_name": "PATRICK",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "64697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Lee Machicek, D.D.S.
• Cheryl Machingura
• Chelsea Kaye Macias, RD
• Sabrina Maciel
• Felicia Kay Macik, D.O.
• Brigitte Madan
• Madden Psychological Services, PLLC
• Maria Madden, PSY.D.
• Jarrod Maddox, OTD, OTR, CHT
• Sudhir Madisetty, M.D.

• Clinical Social Worker in Waco, TX
• Providers in Waco, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.

Verify at the official NPI Registry.