MEDICARE: ELEANOR ELIZABETH WRIGHT 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
1	1041C0700X	Clinical Social Worker	090400458	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053405613
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELEANOR ELIZABETH WRIGHT LCSW

Provider Business Mailing Address
First Line	:	1970 ROANOKE BOULEVARD
Second Line	:
City	:	SALEM
State	:	VA
Zip	:	24153
Country	:	US
Telephone Number	:	540-982-2463
Fax Number	:

Provider Business Practice Location Address
First Line	:	1310 3RD ST SW STE 2
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24016-5219
Country	:	US
Telephone Number	:	540-815-7886
Fax Number	:	833-944-2522

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	02/16/2021

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