1801930946 NPI number — MS. CYNTHIA LEE WRIGHT LPCMH

Table of content: (NPI 1790948040)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801930946 NPI number — MS. CYNTHIA LEE WRIGHT LPCMH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WRIGHT
Provider First Name:
CYNTHIA
Provider Middle Name:
LEE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LPCMH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MOULTON
Provider Other First Name:
CYNTHIA
Provider Other Middle Name:
LEE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
NCC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1801930946
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4311 VERONA DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILMINGTON
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19808-5619
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-999-8646
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
262 CHAPMAN RD
Provider Second Line Business Practice Location Address:
BELLEVUE BUILDING SUITE 100
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19702-5448
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-292-0888
Provider Business Practice Location Address Fax Number:
302-292-0889
Provider Enumeration Date:
02/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  PC-0000172 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 234581 . This is a "COMPSYCH" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 7035494 . This is a "AETNA" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 205933LPC . This is a "BLUECROSSBLUESHIELD" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".




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