Basic Information
Provider Information
NPI: 1285938142
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WRIGHT
FirstName: CHELSEA
MiddleName: ELIZABETH
NamePrefix:  
NameSuffix:  
Credential: LMSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: PIERCE
OtherFirstName: CHELSEA
OtherMiddleName: ELIZABETH
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 9266 NORTHERN AVE
Address2:  
City: PLYMOUTH
State: MI
PostalCode: 48170
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 2140 E ELLSWORTH RD
Address2:  
City: ANN ARBOR
State: MI
PostalCode: 481082552
CountryCode: US
TelephoneNumber: 7342223500
FaxNumber: 7342223461
Other Information
ProviderEnumerationDate: 01/06/2011
LastUpdateDate: 07/25/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000X  Y Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


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