Provider Demographics
NPI:1477241305
Name:WRIGHT, LAURA JEAN (LCSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:JEAN
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 HUNTERS WAY
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-4905
Mailing Address - Country:US
Mailing Address - Phone:361-920-1916
Mailing Address - Fax:
Practice Address - Street 1:1501 E MOCKINGBIRD LN STE 262
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-2194
Practice Address - Country:US
Practice Address - Phone:361-570-8900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-27
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX610641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical