Provider Demographics
NPI:1194225276
Name:WRIGHT, GINA (LLMSW)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:
Other - Last Name:SINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:812 E JOLLY RD STE 311
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-6821
Mailing Address - Country:US
Mailing Address - Phone:517-346-8229
Mailing Address - Fax:
Practice Address - Street 1:812 E JOLLY RD STE 216
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-6821
Practice Address - Country:US
Practice Address - Phone:517-346-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-15
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI680110063104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker