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Individual

MR. JEFFREY D WRIGHT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.A., NCC, LPC

Contact information

Practice address
112 12TH AVE RD, NAMPA, ID 83686-5051
(208) 465-5433
(208) 466-5802
Mailing address
112 12TH AVE RD, NAMPA, ID 83686-5011
(208) 250-4642
(208) 466-5802

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC-3506
ID
101YP2500X
Professional Counselor
Primary
LCPC-4054
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010153421
BLUE SHIELD OF IDAHO
ID
01
LCPC-4054
IDAHO LCPC LICENSURE NUMBER
ID
01
LPC-3506
IDAHO LPC LICENSURE NBR
ID
01
X6881
BLUE CROSS OF IDAHO
ID
Enumeration date
12/11/2006
Last updated
08/08/2024
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