Provider Demographics
NPI:1417523739
Name:WRIGHT, AMY DAWN (MSW, LCSWA)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:DAWN
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 1:1100 W NC HIGHWAY 54 BYP APT 63
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-2890
Mailing Address - Country:US
Mailing Address - Phone:919-995-2262
Mailing Address - Fax:
Practice Address - Street 1:314 CLOISTER CT
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2276
Practice Address - Country:US
Practice Address - Phone:919-514-3566
Practice Address - Fax:919-516-0057
Is Sole Proprietor?:No
Enumeration Date:2021-05-27
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0162141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1528563194OtherGROUP NPI FOR THREE OAKS BEHAVIORAL HEALTH & WELLNESS
NCP016214OtherNC SOCIAL WORK CERTIFICATION AND LICENSURE BOARD