Healthcare Provider Details

I. General information

NPI: 1710807573
Provider Name (Legal Business Name): MARTIN TIMOTHY WRIGHT MA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 WALSH RD
LANSDOWNE PA
19050-2116
US

IV. Provider business mailing address

115 WALSH RD
LANSDOWNE PA
19050-2116
US

V. Phone/Fax

Practice location:
  • Phone: 267-342-2734
  • Fax: 610-623-0010
Mailing address:
  • Phone: 267-342-2734
  • Fax: 610-623-0010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: