Provider Demographics
NPI:1790336097
Name:WRIGHT, BARBARA (LMSW, LCSW, ACHP-SW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LMSW, LCSW, ACHP-SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 OAK PLACE RD
Mailing Address - Street 2:
Mailing Address - City:PONCA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:74604-6052
Mailing Address - Country:US
Mailing Address - Phone:580-304-2730
Mailing Address - Fax:
Practice Address - Street 1:445 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:PONCA CITY
Practice Address - State:OK
Practice Address - Zip Code:74601-1931
Practice Address - Country:US
Practice Address - Phone:580-762-9102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-27
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK70281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical