Healthcare Provider Details

I. General information

NPI: 1841185428
Provider Name (Legal Business Name): BRYNN WRIGHT LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2025
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 W HEMINGWAY BLVD
NAMPA ID
83651-1763
US

IV. Provider business mailing address

290 W SCREECH OWL DR
KUNA ID
83634-3527
US

V. Phone/Fax

Practice location:
  • Phone: 208-505-9990
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2671454
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: