Provider Demographics
NPI:1912240524
Name:WRIGHT, SILAS BENNETT IV (MS, NCC, LPC)
Entity Type:Individual
Prefix:MR
First Name:SILAS
Middle Name:BENNETT
Last Name:WRIGHT
Suffix:IV
Gender:M
Credentials:MS, NCC, LPC
Other - Prefix:MR
Other - First Name:BEN
Other - Middle Name:
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, NCC, LPC
Mailing Address - Street 1:PO BOX 86549
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97286-0549
Mailing Address - Country:US
Mailing Address - Phone:971-266-1558
Mailing Address - Fax:855-662-9131
Practice Address - Street 1:1029 MAY ST STE C
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1514
Practice Address - Country:US
Practice Address - Phone:971-266-1558
Practice Address - Fax:855-662-9131
Is Sole Proprietor?:No
Enumeration Date:2013-04-02
Last Update Date:2021-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3732101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health