Healthcare Provider Details

I. General information

NPI: 1023448917
Provider Name (Legal Business Name): KATIE WRIGHT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2013
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 VILLA NOVA ST
CUTHBERT GA
39840-6221
US

IV. Provider business mailing address

90 VILLA NOVA ST
CUTHBERT GA
39840-6221
US

V. Phone/Fax

Practice location:
  • Phone: 229-366-0906
  • Fax: 229-732-6621
Mailing address:
  • Phone: 229-366-0906
  • Fax: 762-261-3105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW009734
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberMSW008442
License Number StateGA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: