MEDICARE: LEE REIS MA

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	101YM0800X	Mental Health Counselor	LMHC10001840	MA

General Provider Information

NPI Number	:	1558123158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEE REIS MA

Provider Business Mailing Address
First Line	:	3 OLD ANN PAGE WAY
Second Line	:
City	:	PROVINCETOWN
State	:	MA
Zip	:	02657-1579
Country	:	US
Telephone Number	:	508-246-3256
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 NAMSKAKET RD
Second Line	:
City	:	ORLEANS
State	:	MA
Zip	:	02653-3202
Country	:	US
Telephone Number	:	774-701-6977
Fax Number	:

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

Provider Enumeration Date	:	01/29/2024
Last Update Date	:	03/20/2025

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Directions to “ LEE REIS MA” Practice Location

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