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General NPI Number Information
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NPI Number | 1124625108
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Entity Type | Individual
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Provider Name | REN LEE LCSW
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Gender |
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Dates
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Enumeration Date | 10/03/2020
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 224 W 35TH ST STE 500 #2214
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City | NEW YORK
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State | NY
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Zip | 10001-2538
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Country | US
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Telephone | 929-314-3693
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Fax |
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Provider Business Mailing Address
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Address Line | 2431 E 12TH ST
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City | BROOKLYN
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State | NY
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Zip | 11235-5019
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 110475
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 097453
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 089.0136696TELE
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License Number State | VT
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