Provider Demographics
NPI:1245724277
Name:WRIGHT, SHINIQUE (MA, LMFT)
Entity type:Individual
Prefix:
First Name:SHINIQUE
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2824 BIRKHILL LN
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29707-4504
Mailing Address - Country:US
Mailing Address - Phone:215-530-2253
Mailing Address - Fax:
Practice Address - Street 1:435 W HANSBERRY ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-4026
Practice Address - Country:US
Practice Address - Phone:215-530-2253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-22
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF001169106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist