MEDICARE: DAVID ANTHONY WRIGHT MBA, MHSA, MM

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	172V00000X	Community Health Worker
3	174V00000X	Clinical Ethicist
4	174H00000X	Health Educator
5	251V00000X	Voluntary or Charitable Agency

General Provider Information

NPI Number	:	1396577862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID ANTHONY WRIGHT MBA, MHSA, MM

Provider Business Mailing Address
First Line	:	113 ASHBURY DR
Second Line	:
City	:	VILLA RICA
State	:	GA
Zip	:	30180-2541
Country	:	US
Telephone Number	:	207-749-0236
Fax Number	:

Provider Business Practice Location Address
First Line	:	1010 HUNTCLIFF STE 1270
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30350-1809
Country	:	US
Telephone Number	:	404-341-6360
Fax Number	:

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

Provider Enumeration Date	:	08/14/2024
Last Update Date	:	08/14/2024

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