Provider Demographics
NPI:1306295829
Name:WRIGHT, EDDIE EARL JR (LPC, MA)
Entity type:Individual
Prefix:MR
First Name:EDDIE
Middle Name:EARL
Last Name:WRIGHT
Suffix:JR
Gender:M
Credentials:LPC, MA
Other - Prefix:MR
Other - First Name:EDDIE
Other - Middle Name:EARL
Other - Last Name:WRIGHT
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:LPC, MA
Mailing Address - Street 1:16068 LAMONTE DR # 200B
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-1404
Mailing Address - Country:US
Mailing Address - Phone:337-502-8345
Mailing Address - Fax:337-437-4014
Practice Address - Street 1:16068 LAMONTE DR # 200B
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1404
Practice Address - Country:US
Practice Address - Phone:337-502-8345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2023-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 101YM0800X
LA8401101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health