Raevin Ashley Wade
NPI 1053249763ActiveIndividual· Social Worker, Clinical· Hattiesburg, MS
Social Worker, Clinical in Hattiesburg, Mississippi, licensed in MS and AL, with an NPI issued in May 2026. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1053249763 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | May 12, 2026 |
| Last updated in NPPES | Sep 11, 2026 |
| Certified by provider | Sep 11, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | C12013 | MS |
| Social Worker, Clinical | 1041C0700X | 7063C | AL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (MS) |
|---|
Education and affiliations
| Graduation year | 2022 |
|---|---|
| Medicare specialty | Clinical Social Worker |
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All 86 clinical social workers in Hattiesburg · All clinical social workers in Mississippi