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General NPI Number Information
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NPI Number | 1972120350
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Entity Type | Individual
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Provider Name | SEAN S. LEE L.C.S.W.
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Gender | Male
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Dates
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Enumeration Date | 07/01/2020
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 715 21ST AVE
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City | LAKE COMO
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State | NJ
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Zip | 07719-2926
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Country | US
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Telephone | 732-586-1054
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Fax |
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Provider Business Mailing Address
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Address Line | 1020 LARSEN ROAD, APT 6305
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City | JACKSON
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State | NJ
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Zip | 08527-1860
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Country | US
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Telephone | 856-502-4777
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 44SC06440700
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License Number State | NJ
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