Basic Information
Provider Information
NPI: 1841547288
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WRIGHT
FirstName: LUCINDA
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: LADC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 71 HAYNES ST
Address2: MANCHESTER MEMORIAL HOSPITAL
City: MANCHESTER
State: CT
PostalCode: 060404131
CountryCode: US
TelephoneNumber: 8605333494
FaxNumber:  
Practice Location
Address1: 71 HAYNES ST
Address2: MANCHESTER MEMORIAL HOSPITAL
City: MANCHESTER
State: CT
PostalCode: 06040
CountryCode: US
TelephoneNumber: 8605333494
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/03/2012
LastUpdateDate: 08/01/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400X000783CTY Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)

No ID Information.


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