Provider Demographics
NPI:1629540372
Name:MELINDA A WRIGHT LCSW LLC
Entity Type:Organization
Organization Name:MELINDA A WRIGHT LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:407-247-6118
Mailing Address - Street 1:2700 WESTHALL LN STE 110
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7403
Mailing Address - Country:US
Mailing Address - Phone:407-475-1025
Mailing Address - Fax:407-475-1027
Practice Address - Street 1:2700 WESTHALL LN STE 110
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-7403
Practice Address - Country:US
Practice Address - Phone:407-475-1025
Practice Address - Fax:407-475-1027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)