Provider Demographics
NPI:1891667119
Name:WRIGHT, DARRELL CLARENCE (LADC I)
Entity type:Individual
Prefix:
First Name:DARRELL
Middle Name:CLARENCE
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:LADC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9232 AVALON DR # 9232
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02188-4638
Mailing Address - Country:US
Mailing Address - Phone:617-763-2825
Mailing Address - Fax:
Practice Address - Street 1:12 SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02124-2012
Practice Address - Country:US
Practice Address - Phone:617-708-0870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA24327101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)