Provider Demographics
NPI:1457514366
Name:WRIGHT, DAVID RAYMOND (MA, LPC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:RAYMOND
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25769 BROOKVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:BROWNSTOWN TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48134
Mailing Address - Country:US
Mailing Address - Phone:734-775-2932
Mailing Address - Fax:
Practice Address - Street 1:9333 TELEGRAPH RD
Practice Address - Street 2:SUITE 200
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-3386
Practice Address - Country:US
Practice Address - Phone:734-775-2932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401002994101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional