Provider Demographics
NPI:1679782312
Name:WRIGHTEN, VONSHURII S (MDIV, MAC, CACII)
Entity Type:Individual
Prefix:MR
First Name:VONSHURII
Middle Name:S
Last Name:WRIGHTEN
Suffix:
Gender:M
Credentials:MDIV, MAC, CACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:287 AUGUSTA AVE SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30315-1401
Mailing Address - Country:US
Mailing Address - Phone:404-725-0888
Mailing Address - Fax:
Practice Address - Street 1:287 AUGUSTA AVE SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30315-1401
Practice Address - Country:US
Practice Address - Phone:404-725-0888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YP1600X
GA507709101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral