Provider Demographics
NPI:1194290619
Name:WRIGHT, MARION (LGPC)
Entity type:Individual
Prefix:
First Name:MARION
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8548 CROOKED TREE LN
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-2491
Mailing Address - Country:US
Mailing Address - Phone:202-430-0257
Mailing Address - Fax:
Practice Address - Street 1:6201 GREENBELT RD STE M6
Practice Address - Street 2:
Practice Address - City:BERWYN HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20740-2358
Practice Address - Country:US
Practice Address - Phone:202-230-5280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP8291101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional