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General NPI Number Information
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NPI Number | 1629267901
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Entity Type | Individual
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Provider Name | LESLIE L WRIGHT LPC, NCC, ADC, ASDCS
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Gender | Female
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Dates
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Enumeration Date | 10/23/2007
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Last Update Date | 08/10/2022
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Provider Practice Location Address
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Address Line | 204 SHORT ST
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City | KINGSTREE
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State | SC
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Zip | 29556-3927
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Country | US
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Telephone | 843-806-2501
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Fax | 843-484-3641
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Provider Business Mailing Address
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Address Line | 607 3RD AVE
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City | KINGSTREE
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State | SC
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Zip | 29556-2819
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Country | US
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Telephone | 843-372-3365
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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 | 101Y00000X
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Taxonomy Name | 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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 18022210
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 7515
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License Number State | SC
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