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General NPI Number Information
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NPI Number | 1215698618
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Entity Type | Individual
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Provider Name | TONISHA DE'SHAUN LEE LISW-CP
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Gender | Female
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Dates
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Enumeration Date | 01/07/2022
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 460 LANGDON ST
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City | SPARTANBURG
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State | SC
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Zip | 29302-1614
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Country | US
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Telephone | 864-582-2411
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Fax |
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Provider Business Mailing Address
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Address Line | 140 SHERMAN DR
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City | BOILING SPRINGS
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State | SC
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Zip | 29316-4849
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Country | US
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Telephone | 864-789-0055
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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 |
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License Number State |
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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 | 17673
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License Number State | SC
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