Healthcare Provider Details

I. General information

NPI: 1376347732
Provider Name (Legal Business Name): WRIGHT COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2025
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3233 MATHERS RD STE A
SPRINGFIELD IL
62711-7900
US

IV. Provider business mailing address

139 N DOUGLAS AVE
SPRINGFIELD IL
62702-4813
US

V. Phone/Fax

Practice location:
  • Phone: 217-816-2210
  • Fax: 217-679-1125
Mailing address:
  • Phone: 217-816-2210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ELAINE WRIGHT
Title or Position: PRESIDENT
Credential:
Phone: 217-816-2210