Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Wade Anthony Hathaway, LCSW

Individual provider Clinical Social Worker · NPI 1295742724

Mr. Wade Anthony Hathaway, LCSW is a Clinical Social Worker in Bronx, New York. Qualified in 2003, 23 years ago. Licensed in New York.

Years since qualifying
23
Licensed in
NY
In the registry since
2006
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

130 W Kingsbridge Rd 5B-09-C Jj Peters Vamc
Bronx, NY 10468
Phone: (718) 584-9000
Fax: (718) 741-4709
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 72-068851 (NY)

Record details

NPI number1295742724
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorNo
NPI enumeratedAugust 1, 2006
Last updated in NPPESJanuary 12, 2009

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Accepts Medicare assignment Not indicated

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