Healthcare Provider Details

I. General information

NPI: 1871744383
Provider Name (Legal Business Name): LEE A. ALBAN LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2008
Last Update Date: 06/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 W MAIN ST
SAINT CLAIRSVILLE OH
43950-1040
US

IV. Provider business mailing address

PO BOX 118 255 W MAIN STREET
ST. CLAIRSVILLE OH
43950-1040
US

V. Phone/Fax

Practice location:
  • Phone: 740-695-9447
  • Fax: 740-695-8895
Mailing address:
  • Phone: 740-695-9447
  • Fax: 740-695-8895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number041002
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: