=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871777599
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISANNA G WRIGHT LMHC,RD/LD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/18/2007
-----------------------------------------------------
Last Update Date | 06/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 260 NW PEACOCK BLVD STE 102
-----------------------------------------------------
City | PORT ST LUCIE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34986-2349
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-787-3525
-----------------------------------------------------
Fax | 941-257-5550
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 511283
-----------------------------------------------------
City | PUNTA GORDA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33951-1283
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-787-3525
-----------------------------------------------------
Fax | 941-257-5550
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133VN1006X
-----------------------------------------------------
Taxonomy Name | Metabolic Nutrition Registered Dietitian
-----------------------------------------------------
License Number | ND2695
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 9462
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------