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General NPI Number Information
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NPI Number | 1154675163
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Entity Type | Organization
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Legal Business Name | JOHN LEE LMHC
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Dates
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Enumeration Date | 10/30/2012
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Last Update Date | 10/30/2012
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Provider Practice Location Address
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Address Line | 2500 QUANTUM LAKES DR SUITE 203
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-8324
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Country | US
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Telephone | 561-309-4140
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Fax | 561-265-2284
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Provider Business Mailing Address
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Address Line | 2500 QUANTUM LAKES DR SUITE 203
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-8324
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Country | US
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Telephone | 561-309-4140
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Fax | 561-265-2284
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Authorized Official
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Title or Position | OWNER/COUNSLOR
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Name | MR. JOHN HALVER LEE JR.
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Credential | LMHC
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Telephone | 561-309-4140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH5468
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License Number State | FL
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