Provider Demographics
NPI:1679202519
Name:WRIGHT, SAMANTHA LYNN (LLMSW)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:LYNN
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:
Other - Last Name:MARVIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLMSW
Mailing Address - Street 1:121 S BARNARD ST STE 5
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-2939
Mailing Address - Country:US
Mailing Address - Phone:517-774-9600
Mailing Address - Fax:
Practice Address - Street 1:121 S BARNARD ST STE 5
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-2939
Practice Address - Country:US
Practice Address - Phone:517-774-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511021081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical