Provider Demographics
NPI:1144682717
Name:WRIGHT, RACHEL ROBERTA (LMSW)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ROBERTA
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:ROBERTA
Other - Last Name:KANIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:2424 W WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-1236
Mailing Address - Country:US
Mailing Address - Phone:517-205-4001
Mailing Address - Fax:
Practice Address - Street 1:2424 W WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-1236
Practice Address - Country:US
Practice Address - Phone:517-205-4001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-23
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)