Provider Demographics
NPI:1407482862
Name:WRIGHT, JAIME (MSW, LCSWA)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 CHESAPEAKE DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-3526
Mailing Address - Country:US
Mailing Address - Phone:336-707-7247
Mailing Address - Fax:
Practice Address - Street 1:3000 BETHESDA PL STE 801
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3330
Practice Address - Country:US
Practice Address - Phone:336-707-7247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-18
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0134701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical