MEDICARE: KECIA WRIGHT COUNSELING AND COACHING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1487257077
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KECIA WRIGHT COUNSELING AND COACHING

Provider Business Mailing Address
First Line	:	3500 TWINBROOK DR
Second Line	:
City	:	WALDORF
State	:	MD
Zip	:	20603-4087
Country	:	US
Telephone Number	:	240-216-2713
Fax Number	:

Provider Business Practice Location Address
First Line	:	2670 CRAIN HWY STE 510
Second Line	:
City	:	WALDORF
State	:	MD
Zip	:	20601-2819
Country	:	US
Telephone Number	:	240-216-2713
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KECIA WRIGHT
Credential	:
Telephone Number	:	240-216-2713

Provider Enumeration Date	:	11/17/2020
Last Update Date	:	11/17/2020

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