Provider Demographics
NPI:1598978389
Name:WRIGHT, GLORIA (LCPC)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17115 MARYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH HOLLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60473-3449
Mailing Address - Country:US
Mailing Address - Phone:773-919-1486
Mailing Address - Fax:
Practice Address - Street 1:61 DOGWOOD CT
Practice Address - Street 2:
Practice Address - City:CALUMET CITY
Practice Address - State:IL
Practice Address - Zip Code:60409-5007
Practice Address - Country:US
Practice Address - Phone:708-849-8289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-002413101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional