Basic Information
Provider Information
NPI: 1255083457
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BEHN-WRIGHT
FirstName: PATRICIA
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: MA, RMHI. ATR-P
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3840 5TH AVE N
Address2:  
City: SAINT PETERSBURG
State: FL
PostalCode: 337137521
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 3840 5TH AVE N
Address2:  
City: SAINT PETERSBURG
State: FL
PostalCode: 337137521
CountryCode: US
TelephoneNumber: 7273672273
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/19/2022
LastUpdateDate: 01/19/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/19/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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