Provider Demographics
NPI:1093183170
Name:WRIGHT, KEITHA (PHD)
Entity Type:Individual
Prefix:DR
First Name:KEITHA
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8641 HARPS MILL RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3885
Mailing Address - Country:US
Mailing Address - Phone:919-607-6739
Mailing Address - Fax:919-882-1170
Practice Address - Street 1:4030 WAKE FOREST RD
Practice Address - Street 2:SUITE 300
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6800
Practice Address - Country:US
Practice Address - Phone:919-607-6738
Practice Address - Fax:919-882-1170
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-08
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA11673101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health