Provider Demographics
NPI:1346593936
Name:WRIGHT, JOHN BRYON (LMHC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:BRYON
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 NE 16TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304-1182
Mailing Address - Country:US
Mailing Address - Phone:954-931-9165
Mailing Address - Fax:954-462-4214
Practice Address - Street 1:2901 W OAKLAND PARK BLVD
Practice Address - Street 2:SUITE A-1
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33311-1243
Practice Address - Country:US
Practice Address - Phone:954-931-9165
Practice Address - Fax:954-462-4214
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-19
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH2492101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health