Provider Demographics
NPI:1043363245
Name:WRIGHT, MACY P (LPC)
Entity Type:Individual
Prefix:MR
First Name:MACY
Middle Name:P
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239A 3RD ST S
Mailing Address - Street 2:
Mailing Address - City:BRIGANTINE
Mailing Address - State:NJ
Mailing Address - Zip Code:08203-2517
Mailing Address - Country:US
Mailing Address - Phone:609-335-3052
Mailing Address - Fax:
Practice Address - Street 1:20 TOM WELLS RD
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:NJ
Practice Address - Zip Code:08009-9644
Practice Address - Country:US
Practice Address - Phone:609-335-3052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00301500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional