Provider Demographics
NPI:1295818367
Name:WRIGHT, REBECCA MELISSA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:MELISSA
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:REBECCA
Other - Middle Name:MELISSA
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:142 EACH CHURCH STREET
Mailing Address - Street 2:
Mailing Address - City:LOCK HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17745-1321
Mailing Address - Country:US
Mailing Address - Phone:570-502-3439
Mailing Address - Fax:
Practice Address - Street 1:142 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:LOCK HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17745-2008
Practice Address - Country:US
Practice Address - Phone:570-502-3439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002892101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC002892OtherL.P.C.
PA1025490100001Medicaid