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NPI Code Detail

MEDICARE: ANNIE KOPCZESKI-WRIGHT KENNEDY LCSW

MEDICARE: ANNIE KOPCZESKI-WRIGHT KENNEDY LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker0904014874VA

General Provider Information

NPI Number : 1528688488
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNIE KOPCZESKI-WRIGHT KENNEDY LCSW
Provider Business Mailing Address
First Line : 9130 PANTEGO LN
Second Line :
City : MECHANICSVLLE
State : VA
Zip : 23116-5837
Country : US
Telephone Number : 240-342-9018
Fax Number :
Provider Business Practice Location Address
First Line : 6800 PARAGON PL STE 420
Second Line :
City : RICHMOND
State : VA
Zip : 23230-1652
Country : US
Telephone Number : 804-239-7688
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2020
Last Update Date : 02/07/2023

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