Provider Demographics
NPI:1578196556
Name:WRIGHT, BARBARA ELAINE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ELAINE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1603 12TH AVE RD STE B
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-6100
Mailing Address - Country:US
Mailing Address - Phone:208-442-0096
Mailing Address - Fax:
Practice Address - Street 1:1603 12TH AVE RD STE B
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-6100
Practice Address - Country:US
Practice Address - Phone:208-442-0096
Practice Address - Fax:208-442-0536
Is Sole Proprietor?:No
Enumeration Date:2020-02-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-30604104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDLMSW-30604Medicaid