Healthcare Provider Details

I. General information

NPI: 1962091553
Provider Name (Legal Business Name): GREGORY T WRIGHT JR. LPC, LCPC, LCAD-S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2021
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6915 LAUREL BOWIE RD STE 204
BOWIE MD
20715-1715
US

IV. Provider business mailing address

6915 LAUREL BOWIE RD STE 204
BOWIE MD
20715-1715
US

V. Phone/Fax

Practice location:
  • Phone: 301-574-7110
  • Fax:
Mailing address:
  • Phone: 443-942-2361
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPRC200002435
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: