MEDICARE: ALAN J. LEE & ASSOCIATES, LLC

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	SC49358	NJ
2	103TC0700X	Clinical Psychologist	SI3652	NJ

General Provider Information

NPI Number	:	1700044880
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALAN J. LEE & ASSOCIATES, LLC

Provider Business Mailing Address
First Line	:	3379 QUAKERBRIDGE RD
Second Line	:	SUITE 101
City	:	HAMILTON
State	:	NJ
Zip	:	08619-1269
Country	:	US
Telephone Number	:	609-228-3078
Fax Number	:	609-228-3083

Provider Business Practice Location Address
First Line	:	3379 QUAKERBRIDGE RD
Second Line	:	SUITE 101
City	:	HAMILTON
State	:	NJ
Zip	:	08619-1269
Country	:	US
Telephone Number	:	609-228-3078
Fax Number	:	609-228-3083

Authorized Official
Title or Position	:	PRESIDENT/PSYCHOLOGIST
Name	:	DR. ALAN J. LEE
Credential	:	PSY.D.
Telephone Number	:	609-228-3078

Provider Enumeration Date	:	05/27/2008
Last Update Date	:	05/27/2008

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