Healthcare Provider Details

I. General information

NPI: 1306295829
Provider Name (Legal Business Name): EDDIE EARL WRIGHT JR. LPC, M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: EDDIE EARL WRIGHT JR. LPC, M.A.

II. Dates (important events)

Enumeration Date: 06/06/2016
Last Update Date: 02/18/2023
Certification Date: 02/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16068 LAMONTE DR # 200B
HAMMOND LA
70403-1404
US

IV. Provider business mailing address

16068 LAMONTE DR # 200B
HAMMOND LA
70403-1404
US

V. Phone/Fax

Practice location:
  • Phone: 337-502-8345
  • Fax:
Mailing address:
  • Phone: 337-502-8345
  • Fax: 337-437-4014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8401
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: