Provider Demographics
NPI:1184226656
Name:WRIGHT, ANGELA (LPCA)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 SAMS POINT RD STE 105
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29907-1589
Mailing Address - Country:US
Mailing Address - Phone:417-268-5092
Mailing Address - Fax:
Practice Address - Street 1:15 SAMS POINT RD STE 105
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29907-1589
Practice Address - Country:US
Practice Address - Phone:843-441-6337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-10
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7548101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor