Healthcare Provider Details

I. General information

NPI: 1215877493
Provider Name (Legal Business Name): TE'NEIL J LEE LGSW, LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

814 N 11TH ST
MONTEVIDEO MN
56265-1629
US

IV. Provider business mailing address

409 COFIELD ST S
RAYMOND MN
56282-2105
US

V. Phone/Fax

Practice location:
  • Phone: 320-269-2222
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number306762
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number32489
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: