Healthcare Provider Details

I. General information

NPI: 1770970295
Provider Name (Legal Business Name): CATHERINE LEIGH WRIGHT PSY. D.,LP, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2015
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 UNIVERSITY AVE W # 12
SAINT PAUL MN
55104-3898
US

IV. Provider business mailing address

1600 UNIVERSITY AVE W # 12
SAINT PAUL MN
55104-3898
US

V. Phone/Fax

Practice location:
  • Phone: 651-379-5157
  • Fax: 651-379-5159
Mailing address:
  • Phone: 651-379-5157
  • Fax: 651-379-5159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCC00392
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number55423
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6090
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: