Ruby Wade LCSW LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

RUBY WADE LCSW LLC

Practice address

315 Lambert Rd
Bismarck, AR 71929-7704

Phone

(661) 376-0024

NPI assigned

Sep 15, 2025

Last updated

Sep 15, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ruby Wade, LCSWNPI 1073642484

Title

LCSW

Phone

(661) 972-3887

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ruby Delana Wade, LCSW

  • Clinical Social Worker
  • Bismarck, AR
  • NPI 1073642484
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1757894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757894400000",
    "number": "1669343547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19",
            "city": "BISMARCK",
            "state": "AR",
            "postal_code": "719290019",
            "telephone_number": "661-376-0024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 LAMBERT RD",
            "city": "BISMARCK",
            "state": "AR",
            "postal_code": "719297704",
            "telephone_number": "661-376-0024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUBY WADE LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-15",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "RUBY",
        "authorized_official_title_or_position": "LCSW",
        "authorized_official_telephone_number": "661-972-3887",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittney Matthews
• Carolyn McClure, MHPP
• Andrea McDaniel, MHPP
• Mindy D. Menotti
• Heather Roberts, MS, LAC
• Connie Runyan
• Phillip Runyan
• Saundra Leanne Schultz, LPC
• Nancy Shaw, COTA
• Shine Therapy Inc.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Bismarck, AR
• Providers in Bismarck, AR by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.