MEDICARE: LEE AND ASSOCIATES CONSULTANTS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	05130	IA

General Provider Information

NPI Number	:	1013146315
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEE AND ASSOCIATES CONSULTANTS LLC

Provider Business Mailing Address
First Line	:	P.O. BOX 1733. S
Second Line	:	1608 CASSELMAN ST.
City	:	SIOUX CITY
State	:	IA
Zip	:	51102-1733
Country	:	US
Telephone Number	:	712-253-3232
Fax Number	:	712-258-3065

Provider Business Practice Location Address
First Line	:	1608 CASSELMAN
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51103-1628
Country	:	US
Telephone Number	:	712-253-3232
Fax Number	:	712-258-3065

Authorized Official
Title or Position	:	LMSW/THERAPIST/SOCIAL WORKER
Name	:	MRS. FLORA MAE LEE
Credential	:	LMSW
Telephone Number	:	712-253-2325

Provider Enumeration Date	:	07/08/2009
Last Update Date	:	07/09/2009

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