Healthcare Provider Details

I. General information

NPI: 1033387998
Provider Name (Legal Business Name): ANNA MARIA LEE M.S.S.W
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2008
Last Update Date: 03/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 S SEVENTH ST
MC BEE SC
29101-7101
US

IV. Provider business mailing address

645 S SEVENTH ST PO BOX 366
MC BEE SC
29101-7101
US

V. Phone/Fax

Practice location:
  • Phone: 843-335-8291
  • Fax: 843-335-8731
Mailing address:
  • Phone: 843-335-8291
  • Fax: 843-335-8731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

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

# 1
Identifier3337
Identifier TypeOTHER
Identifier StateSC
Identifier IssuerMEDICARE
# 2
Identifier376241
Identifier TypeMEDICAID
Identifier StateSC
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: