Provider Demographics
NPI:1922098631
Name:BRIGHT, JAMES IVEY JR (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:IVEY
Last Name:BRIGHT
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 FLEMING ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-3526
Mailing Address - Country:US
Mailing Address - Phone:828-692-5761
Mailing Address - Fax:828-692-5762
Practice Address - Street 1:712 FLEMING ST
Practice Address - Street 2:SUITE 2
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-3526
Practice Address - Country:US
Practice Address - Phone:828-692-5761
Practice Address - Fax:828-692-5762
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0000001868103G00000X, 103TC0700X
NC2858103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6001087Medicaid
TN3685367Medicaid
TN3685330Medicaid
NC6001087Medicaid
TN3685330Medicaid
TN3685330Medicare ID - Type Unspecified