Provider Demographics
NPI:1427766351
Name:WADE, YVETTE DELINDA (LSW)
Entity type:Individual
Prefix:MS
First Name:YVETTE
Middle Name:DELINDA
Last Name:WADE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 395
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08048-0395
Mailing Address - Country:US
Mailing Address - Phone:862-252-4521
Mailing Address - Fax:
Practice Address - Street 1:221 RIVER STREET
Practice Address - Street 2:9TH FLOOR
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030
Practice Address - Country:US
Practice Address - Phone:212-433-2384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06860800104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker