MEDICARE: DIONNE WRIGHT LCSW-A

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	104100000X	Social Worker	P020451	NC

General Provider Information

NPI Number	:	1558107953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIONNE WRIGHT LCSW-A

Provider Business Mailing Address
First Line	:	721 SEA HORSE CIR APT 201
Second Line	:
City	:	RURAL HALL
State	:	NC
Zip	:	27045-9838
Country	:	US
Telephone Number	:	336-314-1089
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 RENON RD
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27127-5030
Country	:	US
Telephone Number	:	336-314-1089
Fax Number	:

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

Provider Enumeration Date	:	07/04/2024
Last Update Date	:	07/04/2024

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