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General NPI Number Information
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NPI Number | 1023352879
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Entity Type | Individual
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Provider Name | STACY M WRIGHT LPC
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Gender | Female
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Dates
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Enumeration Date | 11/18/2012
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Last Update Date | 04/19/2023
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Provider Practice Location Address
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Address Line | 451 HAYWOOD RD
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City | GREENVILLE
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State | SC
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Zip | 29607-4304
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Country | US
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Telephone | 864-509-0435
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Fax | 864-509-0250
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Provider Business Mailing Address
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Address Line | 201B W BUTLER RD
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City | MAULDIN
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State | SC
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Zip | 29662-2536
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Country | US
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Telephone | 864-509-0435
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 5779
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | 5779
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 7316
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 7380
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License Number State | SC
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Taxonomy #5
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 7316
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License Number State | SD
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Taxonomy #6
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 5779
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License Number State | SC
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