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NPI Code Detail

MEDICARE: EBONY CIARA WRIGHT LPC

MEDICARE:   EBONY CIARA WRIGHT  LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor0701008217VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10701008217OTHERVALICENSE

General Provider Information

NPI Number : 1144884925
Entity Type Code : Individual
Provider Name (Legal Business Name) : EBONY CIARA WRIGHT LPC
Provider Business Mailing Address
First Line : 1801 HIGH ST
Second Line :
City : PORTSMOUTH
State : VA
Zip : 23704-3105
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1801 HIGH ST
Second Line :
City : PORTSMOUTH
State : VA
Zip : 23704-3105
Country : US
Telephone Number : 757-381-6987
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2019
Last Update Date : 07/08/2020

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Directions to “ EBONY CIARA WRIGHT LPC” Practice Location

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