Provider Demographics
NPI:1588368054
Name:WRIGHT, KEYONA SHALICIA (LMSW)
Entity type:Individual
Prefix:
First Name:KEYONA
Middle Name:SHALICIA
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 1:12 GEMSTONE CT
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-7200
Mailing Address - Country:US
Mailing Address - Phone:443-525-5785
Mailing Address - Fax:
Practice Address - Street 1:12 GEMSTONE CT
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-7200
Practice Address - Country:US
Practice Address - Phone:443-525-5785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29624104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker