Provider Demographics
NPI:1710604285
Name:WRIGHT, JULIE LYNNETTE (LCSW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:LYNNETTE
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 1:1214 KATIE CV
Mailing Address - Street 2:
Mailing Address - City:HERNANDO
Mailing Address - State:MS
Mailing Address - Zip Code:38632-8050
Mailing Address - Country:US
Mailing Address - Phone:901-490-1923
Mailing Address - Fax:
Practice Address - Street 1:1214 KATIE CV
Practice Address - Street 2:
Practice Address - City:HERNANDO
Practice Address - State:MS
Practice Address - Zip Code:38632-8050
Practice Address - Country:US
Practice Address - Phone:901-490-1923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN68191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical