Provider Demographics
NPI:1750045076
Name:WRIGHT, AMANDA RICE (LICSW)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:RICE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4904 ASHLEY CIR SE
Mailing Address - Street 2:
Mailing Address - City:OWENS CROSS ROADS
Mailing Address - State:AL
Mailing Address - Zip Code:35763-8007
Mailing Address - Country:US
Mailing Address - Phone:205-240-1842
Mailing Address - Fax:
Practice Address - Street 1:4904 ASHLEY CIR SE
Practice Address - Street 2:
Practice Address - City:OWENS CROSS ROADS
Practice Address - State:AL
Practice Address - Zip Code:35763-8007
Practice Address - Country:US
Practice Address - Phone:205-240-1842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4884C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical