Provider Demographics
NPI:1902939218
Name:WRIGHT-WEST, PHYLLIS (MA)
Entity Type:Individual
Prefix:MRS
First Name:PHYLLIS
Middle Name:
Last Name:WRIGHT-WEST
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:PHYLLIS
Other - Middle Name:J
Other - Last Name:WEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:8829 KIRKSTALL CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-4169
Mailing Address - Country:US
Mailing Address - Phone:919-395-7970
Mailing Address - Fax:919-882-1298
Practice Address - Street 1:8829 KIRKSTALL CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-4169
Practice Address - Country:US
Practice Address - Phone:919-395-7970
Practice Address - Fax:919-395-7970
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6507101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health