Provider Demographics
NPI:1346629185
Name:WRIGHT, ALYCIA E (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ALYCIA
Middle Name:E
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ALYCIA
Other - Middle Name:E
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:3103 ENCANTO DR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88201-6635
Mailing Address - Country:US
Mailing Address - Phone:575-317-4048
Mailing Address - Fax:575-624-2033
Practice Address - Street 1:1000 E 18TH ST
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88201-7532
Practice Address - Country:US
Practice Address - Phone:575-624-1780
Practice Address - Fax:575-624-2033
Is Sole Proprietor?:No
Enumeration Date:2015-05-26
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-07229104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker