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Individual

ELLEN M WRIGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW,BA,LCSW,LMSW,RN

Contact information

Practice address
141 E MAIN ST, WATERBURY CLINICAL SERVICES 2ND FLOOR, WATERBURY, CT 06702-2310
(203) 723-9599
(293) 723-9890
Mailing address
141 E MAIN ST, 4TH FLOOR ADMINISTRATION, WATERBURY, CT 06702-2310
(203) 574-9000
(203) 574-9006

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
1649
CT
1041C0700X
Clinical Social Worker
Primary
9474
CT
163W00000X
Registered Nurse
E43376
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008062580
CT
01
060669107
HEALTHYCT WELLMORE GRP/FACILITY
CT
01
13671856
CAQH
CT
01
D339209 141 MAIN ST
BEACON HEALTH
CT
01
ELIGIBLE NOT APPLIED
MHN TRICARENORTH
CT
01
PENDING
AETNA BEHAVIORAL HEALTH
CT
Enumeration date
03/15/2013
Last updated
09/08/2016
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