Provider Demographics
NPI:1689105140
Name:WRIGHT, JENNIFER MARIE (LCMHC-A)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARIE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LCMHC-A
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:HAYES
Other - Last Name:SCHULZ-KLEYENSTUBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5000 FALLS OF NEUSE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-5480
Mailing Address - Country:US
Mailing Address - Phone:919-865-8710
Mailing Address - Fax:919-784-9184
Practice Address - Street 1:5000 FALLS OF NEUSE RD STE 300
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-5480
Practice Address - Country:US
Practice Address - Phone:919-865-8710
Practice Address - Fax:919-784-9184
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-25
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA11111101YM0800X
246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health