1417138504 NPI number — MISS BRIDGET MARY WRIGHT LCSW

Table of content: MISS BRIDGET MARY WRIGHT LCSW (NPI 1417138504)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417138504 NPI number — MISS BRIDGET MARY WRIGHT LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WRIGHT
Provider First Name:
BRIDGET
Provider Middle Name:
MARY
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CONNOLLY
Provider Other First Name:
BRIDGET
Provider Other Middle Name:
MARY
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
LSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1417138504
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/27/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
222 WHIPPLE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15218-1140
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-512-6715
Provider Business Mailing Address Fax Number:
412-822-1407

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1010 DELAFIELD RD BLDG 69
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15215-1802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-822-1403
Provider Business Practice Location Address Fax Number:
412-822-1407
Provider Enumeration Date:
11/17/2007

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: 104100000X , with the licence number:  SW124475 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: CW018890 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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