Healthcare Provider Details

I. General information

NPI: 1407556392
Provider Name (Legal Business Name): MICHELLE WRIGHT LPC, LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2023
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 BRIDGE ST STE 113
WINSTON SALEM NC
27101-1198
US

IV. Provider business mailing address

915 BRIDGE ST STE 113
WINSTON SALEM NC
27101-1198
US

V. Phone/Fax

Practice location:
  • Phone: 336-281-5597
  • Fax: 336-281-5974
Mailing address:
  • Phone: 336-281-5597
  • Fax: 336-281-5974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number10079
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number17589
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number17589
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: