MEDICARE: ADENA B. LEES LCSW,LISAC,BCETS

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	1041C0700X	Clinical Social Worker	LCSW4103	AZ

General Provider Information

NPI Number	:	1386765188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADENA B. LEES LCSW,LISAC,BCETS

Provider Business Mailing Address
First Line	:	7928 N SUPERNOVA DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85741-1479
Country	:	US
Telephone Number	:	520-404-8466
Fax Number	:

Provider Business Practice Location Address
First Line	:	2292 WEST MAGEE RD.
Second Line	:	SUITE 260
City	:	TUCSON
State	:	AZ
Zip	:	85742
Country	:	US
Telephone Number	:	520-404-8466
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	07/08/2007

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