1306071550 NPI number — MR. WILLIAM THOMAS WRIGHT MSSW, LCSW

Table of content: MR. WILLIAM THOMAS WRIGHT MSSW, LCSW (NPI 1306071550)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306071550 NPI number — MR. WILLIAM THOMAS WRIGHT MSSW, LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WRIGHT
Provider First Name:
WILLIAM
Provider Middle Name:
THOMAS
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MSSW, LCSW
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WRIGHT
Provider Other First Name:
TOMMY
Provider Other Middle Name:
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSSW, LCSW
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1306071550
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/18/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
574 GROVE PARK LOOP
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WETUMPKA
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36093-3791
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
334-514-8956
Provider Business Mailing Address Fax Number:
334-514-8956

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
209 W SPRING ST
Provider Second Line Business Practice Location Address:
SUITE 304
Provider Business Practice Location Address City Name:
SYLACAUGA
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35150-2973
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-401-4695
Provider Business Practice Location Address Fax Number:
256-401-4698
Provider Enumeration Date:
05/18/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  2195C , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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