Healthcare Provider Details

I. General information

NPI: 1467035873
Provider Name (Legal Business Name): RANARDA WRIGHT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2021
Last Update Date: 06/03/2021
Certification Date: 06/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 W WASHINGTON ST
RIDGELAND MS
39157-2416
US

IV. Provider business mailing address

PO BOX 1424
RIDGELAND MS
39158-1424
US

V. Phone/Fax

Practice location:
  • Phone: 601-790-7019
  • Fax:
Mailing address:
  • Phone: 601-790-7019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: