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General NPI Number Information
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NPI Number | 1710368360
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Entity Type | Individual
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Provider Name | KRISTIN LEES L.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 06/09/2015
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Last Update Date | 09/11/2023
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Provider Practice Location Address
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Address Line | 1800 NEW RD STE 100
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City | NORTHFIELD
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State | NJ
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Zip | 08225-2017
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Country | US
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Telephone | 609-338-3021
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Fax |
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Provider Business Mailing Address
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Address Line | 208 JACKSON AVE
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City | NORTHFIELD
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State | NJ
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Zip | 08225-1920
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Country | US
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Telephone | 609-338-3021
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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 | 44SC06264000
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License Number State | NJ
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