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NPI Code Detail

MEDICARE: MRS. JANICE ENDERS LEE LCMHC, LCAS

MEDICARE: MRS. JANICE ENDERS LEE LCMHC, LCAS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor2524NC
2101YM0800XMental Health Counselor9292NC

General Provider Information

NPI Number : 1083127294
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JANICE ENDERS LEE LCMHC, LCAS
Provider Business Mailing Address
First Line : 331 HALE ST
Second Line :
City : BURLINGTON
State : NC
Zip : 27217-3114
Country : US
Telephone Number : 336-213-8028
Fax Number : 336-223-0449
Provider Business Practice Location Address
First Line : 2505 S MEBANE ST STE A-B
Second Line :
City : BURLINGTON
State : NC
Zip : 27215-6385
Country : US
Telephone Number : 336-223-0444
Fax Number : 336-223-0449
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2017
Last Update Date : 06/02/2022

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