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General NPI Number Information
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NPI Number | 1942016274
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Entity Type | Organization
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Legal Business Name | JERELYN LEE THERAPY, LLC.
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Dates
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Enumeration Date | 12/11/2024
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 8201 QUIVIRA RD
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City | LENEXA
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State | KS
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Zip | 66215-2703
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Country | US
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Telephone | 913-395-9335
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Fax |
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Provider Business Mailing Address
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Address Line | 4601 E DOUGLAS AVE STE 150
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City | WICHITA
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State | KS
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Zip | 67218-1032
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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 | OWNER, THERAPIST
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Name | JERELYN GENTRY LEE
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Credential | LCPC
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Telephone | 913-395-9335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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