NPIMap

Individual provider Active NPI

Wade R. Carver, LCSW, CADC

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1629216015
Registry record updated May 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SWB-2022-0852 Issued in NM
Practice address
5400 Gibson Blvd SE Ste 13
Albuquerque, NM 87108-5182
Phone
(505) 383-1165
Fax
(505) 383-1191
NPI assigned
Jan 23, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SWB-2022-0852 NM Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 2004 NM
Addiction (Substance Use Disorder) Counselor 101YA0400X 680108111 MI
Social Worker 104100000X SWB-2022-0852 NM

Addresses

Primary practice location

5400 Gibson Blvd SE Ste 13
Albuquerque, NM 87108-5182

Mailing address

5400 Gibson Blvd SE Ste 13
Albuquerque, NM 87108-5182
Phone (505) 383-1165

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

LicenseStateTypeSpecialty
680108111MIMDAddiction (Substance Use Disorder) Counselor
SWB-2022-0852NMMDSocial Worker
2004NMMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
State of New Mexico CurrentSince May 7, 2023 Accepting new patients

Locations

5400 Gibson Blvd SE
Ste 13
Albuquerque, NM 87108
Phone (505) 383-1165

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1232668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1629216015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 GIBSON BLVD SE STE 13",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871085182",
            "telephone_number": "505-383-1165",
            "fax_number": "505-383-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 GIBSON BLVD SE STE 13",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871085182",
            "telephone_number": "505-383-1165",
            "fax_number": "505-383-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARVER",
        "first_name": "WADE",
        "middle_name": "R.",
        "credential": "LCSW, CADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-23",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "SWB-2022-0852",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "2004",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "680108111",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "SWB-2022-0852",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.