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NPI Code Detail

MEDICARE: CINDY LEE LCSW, LADC

MEDICARE: CINDY LEE LCSW, LADC
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
11041C0700XClinical Social Worker4609OK
2101YA0400XAddiction (Substance Use Disorder) Counselor1066OK

General Provider Information

NPI Number : 1649596461
Entity Type Code : Individual
Provider Name (Legal Business Name) : CINDY LEE LCSW, LADC
Provider Business Mailing Address
First Line : 2311 TERRA TRL
Second Line :
City : EDMOND
State : OK
Zip : 73034-3441
Country : US
Telephone Number : 405-812-5104
Fax Number :
Provider Business Practice Location Address
First Line : 3908 N PENIEL AVE STE 420
Second Line :
City : BETHANY
State : OK
Zip : 73008-3402
Country : US
Telephone Number : 405-812-5104
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2010
Last Update Date : 08/01/2013

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