Healthcare Provider Details

I. General information

NPI: 1386951580
Provider Name (Legal Business Name): STEPHEN WRIGHT LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2010
Last Update Date: 09/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3230 PENNSYLVANIA AVE SE SUITE 213
WASHINGTON DC
20020-3722
US

IV. Provider business mailing address

114 UPSAL ST SE
WASHINGTON DC
20032-2481
US

V. Phone/Fax

Practice location:
  • Phone: 202-583-1181
  • Fax:
Mailing address:
  • Phone: 240-645-6660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPRC1313
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: