Provider Demographics
NPI:1922322106
Name:WRIGHT, JENNIFER (LCSW, LCSW-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LCSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3576 UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2314
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3959 PENDER DR
Practice Address - Street 2:STE. 109
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-6041
Practice Address - Country:US
Practice Address - Phone:571-991-1490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-17
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040073191041C0700X
MD147911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical