MEDICARE: MS. CLARISSA MARIE 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
1	101YP2500X	Professional Counselor	6008	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255749255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CLARISSA MARIE WRIGHT LPC

Provider Business Mailing Address
First Line	:	8620 NE 35TH ST
Second Line	:
City	:	SPENCER
State	:	OK
Zip	:	73084-3206
Country	:	US
Telephone Number	:	405-822-7327
Fax Number	:

Provider Business Practice Location Address
First Line	:	5509 MAIN ST STE 103
Second Line	:
City	:	DEL CITY
State	:	OK
Zip	:	73115-5511
Country	:	US
Telephone Number	:	405-822-7327
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2014
Last Update Date	:	08/06/2025

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