Healthcare Provider Details

I. General information

NPI: 1447390810
Provider Name (Legal Business Name): LEE THOMASON BUDAHN LSATP (VA) LMFT (DC)
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEE CARLYLE THOMASON MS

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 12/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100W PENNSYLVANIA AVE NW FL 4 KAISER PERMANENTE BEHAVIORAL HEALTH
WASHINGTON DC
20037-3201
US

IV. Provider business mailing address

2100 PENNSYLVANIA AVE NW STE W KAISER PERMANENTE BEHAVIORAL HEALTH, 4TH FL
WASHINGTON DC
20037-3227
US

V. Phone/Fax

Practice location:
  • Phone: 202-721-2137
  • Fax: 202-721-2121
Mailing address:
  • Phone: 202-721-2137
  • Fax: 202-721-2121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number0718000187
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberCLSATP#0718000187
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT000044
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: