Healthcare Provider Details

I. General information

NPI: 1215858154
Provider Name (Legal Business Name): ELISE LEE COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4433 PARSONS MILL DR
CASTLE HAYNE NC
28429-4610
US

IV. Provider business mailing address

4433 PARSONS MILL DR
CASTLE HAYNE NC
28429-4610
US

V. Phone/Fax

Practice location:
  • Phone: 336-512-0109
  • Fax:
Mailing address:
  • Phone: 336-512-0109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SPENCER ELISE LEE
Title or Position: LCSW
Credential: MSW, LCSW
Phone: 336-512-0109