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NPI Code Detail

MEDICARE: EMILY MICHELLE LEE

MEDICARE: EMILY MICHELLE LEE
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
1101YM0800XMental Health CounselorPLC11155LA

General Provider Information

NPI Number : 1821881905
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY MICHELLE LEE
Provider Business Mailing Address
First Line : 1000 CHINABERRY DR STE 900
Second Line :
City : BOSSIER CITY
State : LA
Zip : 71111-2455
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 305 E MISSISSIPPI AVE
Second Line :
City : RUSTON
State : LA
Zip : 71270-3905
Country : US
Telephone Number : 318-202-3706
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2025
Last Update Date : 03/04/2026

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Directions to “ EMILY MICHELLE LEE ” Practice Location

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