Healthcare Provider Details

I. General information

NPI: 1003744780
Provider Name (Legal Business Name): ALVIN LEE PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 BRUSH HILL RD
MILTON MA
02186-1030
US

IV. Provider business mailing address

700 HARRISON AVE UNIT 210
BOSTON MA
02118-2631
US

V. Phone/Fax

Practice location:
  • Phone: 617-826-9884
  • Fax:
Mailing address:
  • Phone: 617-826-9884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number225246
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: