Provider Demographics
NPI:1215043021
Name:WAINWRIGHT, JOHN IRVING (LPC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:IRVING
Last Name:WAINWRIGHT
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 1:1506 WILLOW LAWN DR
Mailing Address - Street 2:208
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3413
Mailing Address - Country:US
Mailing Address - Phone:804-288-3421
Mailing Address - Fax:
Practice Address - Street 1:1506 WILLOW LAWN DR
Practice Address - Street 2:208
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3413
Practice Address - Country:US
Practice Address - Phone:804-288-3421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701000870101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional