Healthcare Provider Details

I. General information

NPI: 1780998260
Provider Name (Legal Business Name): LEE OREN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2010
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 CRESCENT AVE
NIANTIC CT
06357-3035
US

IV. Provider business mailing address

19 CRESCENT AVE
NIANTIC CT
06357-3035
US

V. Phone/Fax

Practice location:
  • Phone: 203-376-2658
  • Fax:
Mailing address:
  • Phone: 203-376-2658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number007045
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number101136
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: