Provider Demographics
NPI:1194011528
Name:WRIGHT, ANNE MICHELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MICHELLE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:787 RACETRACK RD
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72019-9461
Mailing Address - Country:US
Mailing Address - Phone:501-794-0519
Mailing Address - Fax:
Practice Address - Street 1:787 RACETRACK RD
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72019-9461
Practice Address - Country:US
Practice Address - Phone:501-794-0519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1081-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical