MEDICARE: LEE A WOODS LCSW PC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	LCSW0585	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881644581
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEE A WOODS LCSW PC

Provider Business Mailing Address
First Line	:	PO BOX 2752
Second Line	:
City	:	PAYSON
State	:	AZ
Zip	:	85547-2752
Country	:	US
Telephone Number	:	928-472-8298
Fax Number	:	928-472-7430

Provider Business Practice Location Address
First Line	:	616 S BEELINE HWY SUITE 108
Second Line	:
City	:	PAYSON
State	:	AZ
Zip	:	85541-5380
Country	:	US
Telephone Number	:	928-472-8298
Fax Number	:	928-472-7430

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. LEE A. WOODS
Credential	:	MSSA
Telephone Number	:	928-472-8298

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	01/29/2008

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