Colleen a. Thebert-Wright, PH.D. LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301012124 Issued in MI

Legal business name

COLLEEN A. THEBERT-WRIGHT, PH.D. LLC

Practice address

4021 W Main St
Suite 100
Kalamazoo, MI 49006-3706

Phone

(269) 384-6055

Fax

(269) 384-6056

NPI assigned

Dec 12, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Colleen A. Thebert-Wright, PH.D.

Title

Owner

Phone

(269) 384-6055

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1386806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386806400000",
    "number": "1225469562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4021 W MAIN ST",
            "address_2": "SUITE 100",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490063706",
            "telephone_number": "269-384-6055",
            "fax_number": "269-384-6056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4021 W MAIN ST",
            "address_2": "SUITE 100",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490063706",
            "telephone_number": "269-384-6055",
            "fax_number": "269-384-6056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEEN A. THEBERT-WRIGHT, PH.D. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-12",
        "last_updated": "2013-12-12",
        "status": "A",
        "authorized_official_last_name": "THEBERT-WRIGHT",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "269-384-6055",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301012124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD PIN",
            "identifier": "P1-0-89-6714-0",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sedona Coleman
• Shyare Coleman
• Tiesha Coleman
• Peter G Coles, MD
• Alan Colestock, PT, ATC
• Alison Collins, DO
• Christina Collins, LPC
• Christopher Collins, LLMSW
• John T Collins Jr., MD
• Kelly Lynn Collins, RN

• Psychologist in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.