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NPI Code Detail

MEDICARE: JADE R LEE

MEDICARE: JADE R LEE
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
1101Y00000XCounselorALC04903AL

General Provider Information

NPI Number : 1568205219
Entity Type Code : Individual
Provider Name (Legal Business Name) : JADE R LEE
Provider Business Mailing Address
First Line : 2830 10TH CT S APT A6
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35205-1246
Country : US
Telephone Number : 205-597-3199
Fax Number :
Provider Business Practice Location Address
First Line : 1700 5TH AVE S
Second Line :
City : JASPER
State : AL
Zip : 35501-5334
Country : US
Telephone Number : 205-530-6007
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2024
Last Update Date : 06/18/2024

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Directions to “ JADE R LEE ” Practice Location

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