Marcus L Wade, LMSW/LCDC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

56749 Issued in TX

Practice address

401 E Front St Ste 145
Tyler, TX 75702-8213

Phone

(903) 372-0349

Fax

(903) 472-5038

NPI assigned

Jul 27, 2012

Sex

Male

Sole proprietor

Yes

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

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1780930768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E FRONT ST STE 145",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028213",
            "telephone_number": "903-372-0349",
            "fax_number": "903-472-5038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E FRONT ST STE 145",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028213",
            "telephone_number": "903-372-0349",
            "fax_number": "903-472-5038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "MARCUS",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "LMSW/LCDC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-27",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "10748",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "56749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Truong Andy Ngoc Vu, DO
• Tuan Duc Vu, DDS
• Svetislava Judith Vukelja, M.D.
• April Denise Waddel
• Latoyia M Wade
• Tiffany Renae' Wade, NP-C
• Roy Brent Wadle, D.O.
• Shelby Young Wager, RD
• Rebecca S Waggoner, NP
• Brittany Wagner, MD

• Clinical Social Worker in Tyler, TX
• Providers in Tyler, 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 Jun 13, 2024; 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.