Provider Demographics
NPI:1477056323
Name:WRIGHT, BRENDA M (MA, LLPC)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:M
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MA, LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 E CHAPIN ST
Mailing Address - Street 2:
Mailing Address - City:CADILLAC
Mailing Address - State:MI
Mailing Address - Zip Code:49601-2203
Mailing Address - Country:US
Mailing Address - Phone:231-429-7684
Mailing Address - Fax:
Practice Address - Street 1:201 N MITCHELL ST
Practice Address - Street 2:
Practice Address - City:CADILLAC
Practice Address - State:MI
Practice Address - Zip Code:49601-1859
Practice Address - Country:US
Practice Address - Phone:231-429-7684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-16
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401010895101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional