Kristen Wren Wade, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

13112-M Issued in AR

Practice address

3358 S 2ND St Ste a-C
Cabot, AR 72023-7873

Phone

(501) 286-6053

NPI assigned

Feb 12, 2020

Last updated

Dec 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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.

• Citizen Advocates, Inc

  dba North Star Behavioral Health Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Malone, NY
  • NPI 1780619064
  NPD

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

{
    "created_epoch": "1581465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1700418266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 PLEASANT GROVE RD",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724057870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3358 S 2ND ST STE A-C",
            "city": "CABOT",
            "state": "AR",
            "postal_code": "720237873",
            "telephone_number": "501-286-6053"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "31 6th St",
            "address_purpose": "LOCATION",
            "city": "Malone",
            "state": "NY",
            "postal_code": "129531246",
            "country_code": "US",
            "telephone_number": "518-483-3261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WADE",
        "first_name": "KRISTEN",
        "middle_name": "WREN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-12",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "106169",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "13112-M",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenni Wood Vaughan, M.S.
• Elizabeth Morgan Verkamp
• Julie A Vermeire, LMSW
• Viki Vinson
• W.Brent Larsen, D.D.S., P.a.
• Wal-Mart Stores, Inc. (Vision Center 30-2587)
• Walgreen Co (Walgreens #10059)
• Walk in Faith, PLLC (Cabot Health & Wellness)
• Walker Therapy Clinic, Inc
• Jeffrey Walker, LCSW

• Social Worker in Cabot, AR
• Providers in Cabot, AR by specialty
• Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.