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General NPI Number Information
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NPI Number | 1053551176
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Entity Type | Organization
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Legal Business Name | FAITH JOY WRIGHT, PSYCHOTHERAPIST, INC
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Dates
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Enumeration Date | 03/02/2009
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Last Update Date | 01/15/2020
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Provider Practice Location Address
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Address Line | 1310 ROCKBRIDGE RD ST. E
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City | STONE MOUNTAIN
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State | GA
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Zip | 30087-3163
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Country | US
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Telephone | 770-381-2230
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Fax | 770-381-2223
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Provider Business Mailing Address
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Address Line | PO BOX 870393
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City | STONE MOUNTAIN
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State | GA
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Zip | 30087-0010
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Country | US
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Telephone | 770-381-2230
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Fax | 770-381-2223
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Authorized Official
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Title or Position | OWNER/PSYCHOTHERAPIST
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Name | FAITH JOY WRIGHT
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Credential | PH.D., LCSW
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Telephone | 770-381-2230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW001828
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License Number State | GA
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