Provider Demographics
NPI:1306049861
Name:WRIGHT, KATHY A (LCPC LMFT LMHC)
Entity type:Individual
Prefix:MS
First Name:KATHY
Middle Name:A
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LCPC LMFT LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1143 S PLYMOUTH CT
Mailing Address - Street 2:#406
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-2061
Mailing Address - Country:US
Mailing Address - Phone:312-505-2044
Mailing Address - Fax:
Practice Address - Street 1:21 JOLIET ST
Practice Address - Street 2:BEHAVIORLAL HEALTH OP
Practice Address - City:DYER
Practice Address - State:IN
Practice Address - Zip Code:46211
Practice Address - Country:US
Practice Address - Phone:219-865-2141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39001450A101YM0800X
IL180002752101YP2500X
IN35000980A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist