Provider Demographics
NPI:1891815221
Name:WRIGHT, JAMES ALLEN (LCPC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ALLEN
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 WINTHROP ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-5544
Mailing Address - Country:US
Mailing Address - Phone:207-621-0310
Mailing Address - Fax:207-621-0311
Practice Address - Street 1:74 WINTHROP ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-5544
Practice Address - Country:US
Practice Address - Phone:207-621-0310
Practice Address - Fax:207-621-0311
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC2754101YP2500X
CAME18684106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist