Provider Demographics
NPI:1578027595
Name:JINA WRIGHT, LLC
Entity Type:Organization
Organization Name:JINA WRIGHT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-889-1606
Mailing Address - Street 1:11630 WESTWOOD LN
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-4344
Mailing Address - Country:US
Mailing Address - Phone:402-889-1606
Mailing Address - Fax:
Practice Address - Street 1:1243 S 119TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-1603
Practice Address - Country:US
Practice Address - Phone:402-889-1606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty