Jonathan Richard Wade Sr., LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW8569 Issued in FL

Practice address

10000 Bay Pines Blvd.
Dom C-180
Bay Pines, FL 33744

Phone

(727) 398-6661

Fax

(727) 398-9509

NPI assigned

Jul 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Jonathan Richard Wade Sr. Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218499200000",
    "number": "1861416927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 PENNSYLVANIA AVE",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337554239",
            "telephone_number": "727-398-6661",
            "fax_number": "727-398-9509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 BAY PINES BLVD.",
            "address_2": "DOM C-180",
            "city": "BAY PINES",
            "state": "FL",
            "postal_code": "33744",
            "telephone_number": "727-398-6661",
            "fax_number": "727-398-9509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "JONATHAN",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2008-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW8569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JONATHAN",
            "last_name": "WADE",
            "middle_name": "RICHARD",
            "prefix": "MR.",
            "suffix": "SR.",
            "credential": "CERTIFIED ADDICTION",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Veterans Administration
• Veterans Administration
• Lorraine Vitale, ART THERAPIST
• Alice Vogel
• Bavna Bagyalakshmi Vyas, M.D.
• Suraj Wagh, RN
• Trista Maria Wagoner, PHARMD
• Jessica Wallace, RDN, LDN
• Jacqueline Lee Walsch, PH.D., ARNP
• Hong Wang, APRN

• Clinical Social Worker in Bay Pines, FL
• Providers in Bay Pines, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2008; 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.