Provider Demographics
NPI:1992982219
Name:STEPHEN L WRIGHT PHD
Entity type:Organization
Organization Name:STEPHEN L WRIGHT PHD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:850-877-5655
Mailing Address - Street 1:1320 CHERRY LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5104
Mailing Address - Country:US
Mailing Address - Phone:850-877-5655
Mailing Address - Fax:850-877-5610
Practice Address - Street 1:1320 CHERRY LAUREL ST
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5104
Practice Address - Country:US
Practice Address - Phone:850-877-5655
Practice Address - Fax:850-877-5610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0004349103T00000X
FL873002363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL73636Medicare PIN
S25548Medicare UPIN