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General NPI Number Information
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NPI Number | 1609670678
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Entity Type | Organization
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Legal Business Name | SELF MADE PSYCHOLOGICAL SERVICES PLLC
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Dates
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Enumeration Date | 04/01/2025
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Last Update Date | 04/04/2025
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Provider Practice Location Address
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Address Line | 44 COURT ST STE 1202
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City | BROOKLYN
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State | NY
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Zip | 11201-4410
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Country | US
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Telephone | 773-220-3537
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Fax |
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Provider Business Mailing Address
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Address Line | 44 COURT ST STE 1202
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City | BROOKLYN
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State | NY
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Zip | 11201-4410
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LAUREL WRIGHT
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Credential | PHD
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Telephone | 773-220-3537
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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