=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376664516
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | J.P. LEE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/03/2007
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 421 N OAK ST
-----------------------------------------------------
City | NORTH PLATTE
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 69101-3764
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 308-532-8300
-----------------------------------------------------
Fax | 308-532-4329
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 421 N OAK ST
-----------------------------------------------------
City | NORTH PLATTE
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 69101-3764
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 308-532-8300
-----------------------------------------------------
Fax | 308-532-4329
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CO-OWNER THERAPIST
-----------------------------------------------------
Name | JERRI PHILLIPS
-----------------------------------------------------
Credential | LMHP
-----------------------------------------------------
Telephone | 308-532-8300
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number | 398
-----------------------------------------------------
License Number State | NE
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 1411
-----------------------------------------------------
License Number State | NE
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number | P-521
-----------------------------------------------------
License Number State | NE
-----------------------------------------------------