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General NPI Number Information
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NPI Number | 1407289523
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Entity Type | Individual
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Provider Name | JOSEPH R LEE LCSW
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Gender | Male
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Dates
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Enumeration Date | 08/13/2013
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Last Update Date | 08/13/2013
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Provider Practice Location Address
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Address Line | 700 BAKER RD STE 108 DOVE LANDING PROFESSIONAL BLDG
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-1077
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Country | US
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Telephone | 757-460-4477
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Fax | 757-233-7299
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Provider Business Mailing Address
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Address Line | 5433 SHADOWWOOD DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-3516
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Country | US
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Telephone | 757-478-3989
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Fax | 757-233-7299
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904006698
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License Number State | VA
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