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General NPI Number Information
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NPI Number | 1134700933
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Entity Type | Individual
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Provider Name | JESSICA WRIGHT LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/14/2021
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Last Update Date | 04/14/2021
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Provider Practice Location Address
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Address Line | 2632 E THOMAS RD STE 100
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City | PHOENIX
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State | AZ
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Zip | 85016-8220
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Country | US
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Telephone | 602-957-2507
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Fax |
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Provider Business Mailing Address
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Address Line | 1210 E BETHANY HOME RD APT 210
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City | PHOENIX
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State | AZ
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Zip | 85014-2089
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Country | US
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Telephone | 717-379-7025
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW-18723
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | L12349
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License Number State | OR
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