Provider Demographics
NPI:1437595519
Name:MCDOUGAL, JENNIFER J WRIGHT (PHD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:J WRIGHT
Last Name:MCDOUGAL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:JILL
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:1752 HERITAGE CENTER DR STE 201
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-8790
Mailing Address - Country:US
Mailing Address - Phone:919-302-8800
Mailing Address - Fax:
Practice Address - Street 1:1752 HERITAGE CENTER DR STE 201
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-8790
Practice Address - Country:US
Practice Address - Phone:919-302-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-16
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2161101YA0400X
NC14160101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)