Healthcare Provider Details

I. General information

NPI: 1417367806
Provider Name (Legal Business Name): AMBER RAE LEE M.A., L.P.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2014
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 MORRIS RD
EXTON PA
19341-1537
US

IV. Provider business mailing address

118 MORRIS RD
EXTON PA
19341-1537
US

V. Phone/Fax

Practice location:
  • Phone: 610-679-1840
  • Fax:
Mailing address:
  • Phone: 610-679-1840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC007472
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC007472
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: