Provider Demographics
NPI:1699447250
Name:WRIGHT, JADA (LCSWA)
Entity type:Individual
Prefix:
First Name:JADA
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 LOWER CAPE DR SW APT 201
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-0090
Mailing Address - Country:US
Mailing Address - Phone:704-956-7832
Mailing Address - Fax:
Practice Address - Street 1:195 LOWER CAPE DR SW APT 201
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-0090
Practice Address - Country:US
Practice Address - Phone:704-956-7832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-01
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0169321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical