Provider Demographics
NPI:1942948559
Name:WRIGHT, MARY ELEASE (LPC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ELEASE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:E
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1716 HILLYER ROBINSON INDUSTRIAL PKWY S APT C19
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36203-1361
Mailing Address - Country:US
Mailing Address - Phone:256-525-6021
Mailing Address - Fax:
Practice Address - Street 1:1716 HILLYER ROBINSON PKWY
Practice Address - Street 2:C19
Practice Address - City:OXFORD
Practice Address - State:AL
Practice Address - Zip Code:36203
Practice Address - Country:US
Practice Address - Phone:256-525-6021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4593101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional