Provider Demographics
NPI:1255024055
Name:WRIGHT, BETHANY LEIGH (MSW)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:LEIGH
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3129 CONNECTICUT AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-3334
Mailing Address - Country:US
Mailing Address - Phone:704-277-0550
Mailing Address - Fax:
Practice Address - Street 1:1942 E 7TH ST STE 220
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2418
Practice Address - Country:US
Practice Address - Phone:043-603-6377
Practice Address - Fax:980-939-8770
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
NCP0194141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical