Provider Demographics
NPI:1356443998
Name:WRIGHT, KATHRYN JENNIFER (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:JENNIFER
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 1:60 ACADEMY RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3103
Mailing Address - Country:US
Mailing Address - Phone:518-793-6212
Mailing Address - Fax:518-793-9499
Practice Address - Street 1:35 BROAD ST
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-4302
Practice Address - Country:US
Practice Address - Phone:518-793-6212
Practice Address - Fax:518-793-9499
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-03
Last Update Date:2017-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR048044-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA5059Medicare ID - Type Unspecified
NYQ31228Medicare UPIN