Provider Demographics
NPI:1164044087
Name:WRIGHT, EDNITA MARIE (PHD, LCSW, CASAC)
Entity type:Individual
Prefix:DR
First Name:EDNITA
Middle Name:MARIE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:PHD, LCSW, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 ALANSON RD
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13207-1503
Mailing Address - Country:US
Mailing Address - Phone:315-289-5580
Mailing Address - Fax:
Practice Address - Street 1:135 ALANSON RD
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13207-1503
Practice Address - Country:US
Practice Address - Phone:315-289-5580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071908-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical