Provider Demographics
NPI:1689015166
Name:WRIGHT, COURTNEY PRESTON (LCSW)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:PRESTON
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 1:412 WESTRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411
Mailing Address - Country:US
Mailing Address - Phone:773-504-2550
Mailing Address - Fax:
Practice Address - Street 1:1133 MILITARY CUTOFF RD
Practice Address - Street 2:STE 210
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-4400
Practice Address - Country:US
Practice Address - Phone:312-695-2172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-11
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0093681041C0700X
IL149.0158441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty