| Faith Joy Wright, Psychotherapist, Inc | |
|
1310 Rockbridge Rd St. E Stone Mountain GA 30087-3163 | |
| (770) 381-2230 | |
| (770) 381-2223 |
| Full Name | Faith Joy Wright, Psychotherapist, Inc |
|---|---|
| Speciality | Social Worker |
| Location | 1310 Rockbridge Rd, Stone Mountain, Georgia |
| Authorized Official Name and Position | Faith Joy Wright (OWNER/PSYCHOTHERAPIST) |
| Authorized Official Contact | 7703812230 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Faith Joy Wright, Psychotherapist, Inc Po Box 870393 Stone Mountain GA 30087-0010 Ph: (770) 381-2230 | Faith Joy Wright, Psychotherapist, Inc 1310 Rockbridge Rd St. E Stone Mountain GA 30087-3163 Ph: (770) 381-2230 |
| NPI Number | 1053551176 |
|---|---|
| Provider Enumeration Date | 03/02/2009 |
| Last Update Date | 01/15/2020 |
| Certification Date | 01/15/2020 |
| Medicare PECOS PAC ID | 4486684511 |
|---|---|
| Medicare Enrollment ID | O20090729000554 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053551176 | NPI | - | NPPES |
| 247997521A | Medicaid | GA | |
| 247997521B | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CSW001828 (Georgia) | Primary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Faith J Wright |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164593828 PECOS PAC ID: 2769447283 Enrollment ID: I20041124000093 |
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