Provider Demographics
NPI:1962541623
Name:HOVEY WRIGHT, MARCIA (ACSW)
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:
Last Name:HOVEY WRIGHT
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:452 W WEBSTER AVE
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49440-1046
Mailing Address - Country:US
Mailing Address - Phone:231-726-4929
Mailing Address - Fax:231-722-3021
Practice Address - Street 1:452 W WEBSTER AVE
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49440-1046
Practice Address - Country:US
Practice Address - Phone:231-726-4929
Practice Address - Fax:231-722-3021
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010125931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M00770Medicare ID - Type Unspecified