MEDICARE: MRS. SARAH LYNN LEE LMFT

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	101YP2500X	Professional Counselor		NM
2	106H00000X	Marriage & Family Therapist	86371	NM

General Provider Information

NPI Number	:	1558350918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SARAH LYNN LEE LMFT

Provider Business Mailing Address
First Line	:	6448 HOPS CT NW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87120-4286
Country	:	US
Telephone Number	:	505-710-3255
Fax Number	:

Provider Business Practice Location Address
First Line	:	4125 CARLISLE BLVD NE STE D
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87107-4806
Country	:	US
Telephone Number	:	505-420-2645
Fax Number	:

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

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	12/09/2022

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