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NPI Code Detail

MEDICARE: DANA LEE LCSW

MEDICARE: DANA LEE LCSW
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
11041C0700XClinical Social Worker44SC05742500NJ

General Provider Information

NPI Number : 1538576665
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANA LEE LCSW
Provider Business Mailing Address
First Line : 10175 SPRING MOUNTAIN RD UNIT 2161
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-8484
Country : US
Telephone Number : 609-658-6360
Fax Number :
Provider Business Practice Location Address
First Line : 4461 E CHARLESTON BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-5537
Country : US
Telephone Number : 702-791-9000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2014
Last Update Date : 12/13/2023

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