Provider Demographics
NPI:1023448917
Name:WRIGHT, KATIE (LMSW)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 CLEBOURNE ST
Mailing Address - Street 2:
Mailing Address - City:CUTHBERT
Mailing Address - State:GA
Mailing Address - Zip Code:39840
Mailing Address - Country:US
Mailing Address - Phone:229-732-3981
Mailing Address - Fax:229-732-6621
Practice Address - Street 1:90 VILLA NOVA ST
Practice Address - Street 2:
Practice Address - City:CUTHBERT
Practice Address - State:GA
Practice Address - Zip Code:39840-6221
Practice Address - Country:US
Practice Address - Phone:229-366-0906
Practice Address - Fax:229-732-6621
Is Sole Proprietor?:No
Enumeration Date:2013-11-14
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW008442104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker