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NPI Code Detail

MEDICARE: CANDICE WRIGHT LPC

MEDICARE: CANDICE 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
1101YM0800XMental Health Counselor5423OK

General Provider Information

NPI Number : 1790003937
Entity Type Code : Individual
Provider Name (Legal Business Name) : CANDICE WRIGHT LPC
Provider Business Mailing Address
First Line : 6111 E SKELLY DR
Second Line :
City : TULSA
State : OK
Zip : 74135-6100
Country : US
Telephone Number : 918-273-1841
Fax Number : 918-999-0111
Provider Business Practice Location Address
First Line : 6111 E SKELLY DR
Second Line :
City : TULSA
State : OK
Zip : 74135-6100
Country : US
Telephone Number : 918-273-1841
Fax Number : 918-999-0111
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2010
Last Update Date : 04/04/2025

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