Healthcare Provider Details

I. General information

NPI: 1386360477
Provider Name (Legal Business Name): AL'CAEUS F. WRIGHT LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2022
Last Update Date: 10/19/2022
Certification Date: 10/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

917 WESTERN AMERICA CIR STE 205
MOBILE AL
36609-4114
US

IV. Provider business mailing address

PO BOX 240912
MONTGOMERY AL
36124-0912
US

V. Phone/Fax

Practice location:
  • Phone: 800-381-2309
  • Fax: 334-247-3902
Mailing address:
  • Phone: 800-381-2309
  • Fax: 334-247-3902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC04695
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: