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General NPI Number Information
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NPI Number | 1285589291
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Entity Type | Individual
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Provider Name | SUEBIN LEE LAC, MHC-LP
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Gender | Female
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Dates
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Enumeration Date | 03/04/2026
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Last Update Date | 03/04/2026
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Provider Practice Location Address
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Address Line | 2460 LEMOINE AVE STE 400B
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City | FORT LEE
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State | NJ
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Zip | 07024-6210
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Country | US
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Telephone | 917-946-3444
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Fax |
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Provider Business Mailing Address
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Address Line | 738 WOODROW RD
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City | STATEN ISLAND
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State | NY
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Zip | 10312-2220
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 7AC00904700
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License Number State | NJ
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