MEDICARE: LEE PELLETIER MENTAL HEALTH COUNSELING,PLLC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1114897014
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEE PELLETIER MENTAL HEALTH COUNSELING,PLLC

Provider Business Mailing Address
First Line	:	2 GUY PARK AVE
Second Line	:
City	:	AMSTERDAM
State	:	NY
Zip	:	12010-4117
Country	:	US
Telephone Number	:	646-637-6983
Fax Number	:	518-309-6884

Provider Business Practice Location Address
First Line	:	2 GUY PARK AVE
Second Line	:
City	:	AMSTERDAM
State	:	NY
Zip	:	12010-4117
Country	:	US
Telephone Number	:	518-844-3949
Fax Number	:	518-309-6884

Authorized Official
Title or Position	:	DIRECTOR OF REVENUE CYCLE
Name	:	MS. YVONNE DEACON
Credential	:
Telephone Number	:	646-637-6983

Provider Enumeration Date	:	11/06/2025
Last Update Date	:	11/24/2025

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