Provider Demographics
NPI:1558802173
Name:WRIGHT, URSULA (LCSW)
Entity Type:Individual
Prefix:
First Name:URSULA
Middle Name:
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 1:2900 CHAMBLEE TUCKER RD
Mailing Address - Street 2:BLDG 16
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-4100
Mailing Address - Country:US
Mailing Address - Phone:770-939-1288
Mailing Address - Fax:
Practice Address - Street 1:2900 CHAMBLEE TUCKER RD
Practice Address - Street 2:BLDG 16
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30341-4100
Practice Address - Country:US
Practice Address - Phone:770-939-1288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-15
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0053921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical