Individual
EDWARD SPADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
94 STEVENS RD, TOMS RIVER, NJ 08755-1490
(732) 914-1100
(732) 797-3830
Mailing address
73 AUSTIN ST, TINTON FALLS, NJ 07712-7759
(732) 762-3579
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05365500
NJ
1041C0700X
Clinical Social Worker
SW7668
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z105X
BCBS PROVIDER NUMBER
FL
Enumeration date
05/05/2006
Last updated
06/08/2012
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