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General NPI Number Information
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NPI Number | 1811574395
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Entity Type | Organization
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Legal Business Name | SOO-IL LEE MENTAL HEALTH COUNSELING, P.C.
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Dates
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Enumeration Date | 03/29/2021
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Last Update Date | 03/29/2021
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Provider Practice Location Address
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Address Line | 22016 UNION TPKE
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City | OAKLAND GARDENS
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State | NY
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Zip | 11364-3543
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Country | US
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Telephone | 516-395-8706
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Fax |
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Provider Business Mailing Address
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Address Line | 502 WILLOW LN
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City | VALLEY STREAM
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State | NY
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Zip | 11580-7020
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Country | US
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Telephone | 516-395-8706
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/DIRECTOR
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Name | SOO-IL LEE
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Credential | LMHC
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Telephone | 516-395-8706
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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 |
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License Number State |
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