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NPI Code Detail

MEDICARE: ANDREW JOON LEE

MEDICARE: ANDREW JOON LEE
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
1101YM0800XMental Health Counselor
21041C0700XClinical Social Worker6801116852MI

General Provider Information

NPI Number : 1043834476
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW JOON LEE
Provider Business Mailing Address
First Line : PO BOX 30161
Second Line :
City : LANSING
State : MI
Zip : 48909-7661
Country : US
Telephone Number : 517-887-4383
Fax Number : 517-244-7174
Provider Business Practice Location Address
First Line : 2316 S CEDAR ST
Second Line :
City : LANSING
State : MI
Zip : 48910-3152
Country : US
Telephone Number : 517-887-4302
Fax Number : 517-887-4437
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2020
Last Update Date : 03/04/2026

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