Provider Demographics
NPI:1952599961
Name:WRIGHT, KELLI (LCSW)
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:
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 1:496 HIGHWAY 67 S
Mailing Address - Street 2:STE A
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35603-6300
Mailing Address - Country:US
Mailing Address - Phone:256-229-3535
Mailing Address - Fax:256-615-8689
Practice Address - Street 1:496 HIGHWAY 67 S STE A
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603-6300
Practice Address - Country:US
Practice Address - Phone:256-229-3535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-04
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1597C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51539979OtherBCBS OF AL
AL51541281OtherFEDERAL BCBS
AL581428OtherVALUE OPTIONS
AL600019760OtherMAGELLAN