Provider Demographics
NPI:1740993427
Name:WRIGHT, ROBERT JOHN (LGSW)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:JOHN
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:LGSW
Other - Prefix:MR
Other - First Name:ROBERT
Other - Middle Name:JOHN
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SOCIAL WORKER, LGSW
Mailing Address - Street 1:1502 ERSKINE ST
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-7008
Mailing Address - Country:US
Mailing Address - Phone:202-630-5809
Mailing Address - Fax:
Practice Address - Street 1:1502 ERSKINE ST
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-7008
Practice Address - Country:US
Practice Address - Phone:202-630-5809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLG101928104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker