Healthcare Provider Details

I. General information

NPI: 1154150134
Provider Name (Legal Business Name): MARGARET BURGESS-WRIGHT ED.D., LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 07/29/2024
Certification Date: 07/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3307 LANTERN COACH LN NE
ROSWELL GA
30075-3196
US

IV. Provider business mailing address

3307 LANTERN COACH LN NE
ROSWELL GA
30075-3196
US

V. Phone/Fax

Practice location:
  • Phone: 404-272-8057
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number006624
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number735882
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: