Holly Elizabeth Wade, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6138 Issued in TN

Practice address

801 N Holtzclaw Ave Ste 101
Chattanooga, TN 37404-1236

Phone

(423) 697-5953

Fax

(615) 743-1679

NPI assigned

Dec 10, 2014

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

Other names 1

• Holly Wade Kelly Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 1, 2019 through Jul 1, 2027

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Holly Wade LCSW LLC

  • Clinical Social Worker
  • Chattanooga, TN
  • NPI 1770059768
  NPD Authorized official
• Holly Kelly LCSW LLC

  • Clinical Social Worker
  • Norwalk, CT
  • NPI 1992195945
  NPD (past)

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

{
    "created_epoch": "1418169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1760880504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 CUMBERLAND BND",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372281805",
            "telephone_number": "615-726-3340",
            "fax_number": "615-743-1679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N HOLTZCLAW AVE STE 101",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041236",
            "telephone_number": "423-697-5953",
            "fax_number": "615-743-1679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29 Stony Brook Rd",
            "address_purpose": "LOCATION",
            "city": "Darien",
            "state": "CT",
            "postal_code": "068204325",
            "country_code": "US",
            "telephone_number": "203-918-0336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WADE",
        "first_name": "HOLLY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-10",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "008834",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "6138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "KELLY",
            "middle_name": "WADE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Heather Ellison Waddell, PHARM D
• Jeremy B. Waddell, P.A.-C.
• Casey M. Waddle, NP
• Wade in the Water Medicine LLC
• Cynthia Wade
• Jason Daniel Wade, RN
• Katie Danielle Wade, MSN, APRN, PMHNP-BC
• Robin E. Wade
• Shaun Michael Wade
• Sydney Caroline Wade

• Clinical Social Worker in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.