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NPI Code Detail

MEDICARE: LEE PSYCHOLOGY GROUP PLLC

MEDICARE: LEE PSYCHOLOGY GROUP PLLC
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
1103TC0700XClinical Psychologist

General Provider Information

NPI Number : 1265386775
Entity Type Code : Organization
Provider Name (Legal Business Name) : LEE PSYCHOLOGY GROUP PLLC
Provider Business Mailing Address
First Line : 82 WENDELL AVE STE 100
Second Line :
City : PITTSFIELD
State : MA
Zip : 01201-7066
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 82 WENDELL AVE STE 100
Second Line :
City : PITTSFIELD
State : MA
Zip : 01201-7066
Country : US
Telephone Number : 646-512-2159
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. JASPER SAMUEL LEE
Credential : PHD
Telephone Number : 646-512-2159
Provider Enumeration Date : 02/23/2026
Last Update Date : 02/23/2026

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Directions to “LEE PSYCHOLOGY GROUP PLLC ” Practice Location

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