Healthcare Provider Details

I. General information

NPI: 1346629185
Provider Name (Legal Business Name): ALYCIA E WRIGHT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALYCIA E MILLER LMSW

II. Dates (important events)

Enumeration Date: 05/26/2015
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E 18TH ST
ROSWELL NM
88201-7532
US

IV. Provider business mailing address

3103 ENCANTO DR
ROSWELL NM
88201-6635
US

V. Phone/Fax

Practice location:
  • Phone: 575-624-1780
  • Fax: 575-624-2033
Mailing address:
  • Phone: 575-317-4048
  • Fax: 575-624-2033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC-09824
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberM-07229
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: