Individual provider Active NPI

Mia Y Wright, MBA, LCSW

  • Clinical Social Worker
  • Peachtree City, GA
National Provider Identifier
1245649581
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW006385 Issued in GA
Practice address
2011 Commerce Dr N
Peachtree City, GA 30269-3538
Phone
(470) 483-6929
Fax
(866) 260-5504
NPI assigned
Aug 12, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Health Educator 174H00000X
Clinical Social Worker 1041C0700X CSW006385 GA Primary

Addresses

Primary practice location

2011 Commerce Dr N
Peachtree City, GA 30269-3538

Mailing address

5676 Norman PL
Atlanta, GA 30349-6982
Phone (770) 875-5504

Other practice location 1

1175 Green St SE
Conyers, GA 30012-5407
Phone (770) 875-5504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
CSW006385GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Care Resources of Georgia, LLC CurrentSince Aug 11, 2019 Accepting new patients
Integrated Care Resources, Inc CurrentSince Aug 11, 2019 Accepting new patients

Locations

1175 Green St SE
Conyers, GA 30012
Phone (770) 875-5504

2011 Commerce Dr N
Peachtree City, GA 30269
Phone (470) 483-6929

401 Westpark Ct
Ste 200
Peachtree City, GA 30269
Phone (678) 783-0130

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1407801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1245649581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5676 NORMAN PL",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303496982",
            "telephone_number": "770-875-5504",
            "fax_number": "866-260-5504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 COMMERCE DR N",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302693538",
            "telephone_number": "470-483-6929",
            "fax_number": "866-260-5504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1175 Green St SE",
            "address_purpose": "LOCATION",
            "city": "Conyers",
            "state": "GA",
            "postal_code": "300125407",
            "country_code": "US",
            "telephone_number": "770-875-5504",
            "fax_number": "866-260-5504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "MIA",
        "middle_name": "Y",
        "credential": "MBA, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-12",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peachtree City, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.