Active NPI
Stephanie Berg Wright, MS
- Counseling Psychologist
- Southfield, MI
National Provider Identifier
1003173063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 6301014114
- Practice address
- 30503 Greenfield Rd
Southfield, MI 48076-1594 - Phone
- (248) 691-4744
- Fax
- (248) 691-4745
- NPI assigned
- Apr 16, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401011218 | MI | |
| Counseling Psychologist | 103TC1900X | 6301014114 | MI | Primary |
Addresses
Primary practice location
30503 Greenfield Rd
Southfield, MI 48076-1594
Mailing address
26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Phone (947) 522-1867
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6401011218 | Other | MI | STATE LICENSE |
| 6301014114 | Other | MI | STATE LICENSE NUMBER |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | swright74573@direct.beaumont.edu |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401011218 | MI | MD | Professional Counselor |
| 6301014114 | MI | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603324800000",
"number": "1003173063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26901 BEAUMONT BLVD STE 3D",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480333849",
"telephone_number": "947-522-1867",
"fax_number": "947-522-0301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30503 GREENFIELD RD",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480761594",
"telephone_number": "248-691-4744",
"fax_number": "248-691-4745"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WRIGHT",
"first_name": "STEPHANIE",
"middle_name": "BERG",
"credential": "MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-16",
"last_updated": "2020-10-22",
"certification_date": "2020-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401011218",
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MI",
"license": "6301014114",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "6401011218",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "6301014114",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "swright74573@direct.beaumont.edu",
"affiliation": "N",
"address_1": "30503 Greenfield Rd",
"city": "Southfield",
"state": "MI",
"country_code": "US",
"postal_code": "480761594",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.