Healthcare Provider Details

I. General information

NPI: 1225947443
Provider Name (Legal Business Name): IAN WRIGHT JD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

87 CARROLL AVE
KEYSER WV
26726-5022
US

IV. Provider business mailing address

12410 BUCK CROSS LN NE
CUMBERLAND MD
21502-8238
US

V. Phone/Fax

Practice location:
  • Phone: 304-790-7467
  • Fax:
Mailing address:
  • Phone: 304-790-7467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: