Provider Demographics
NPI:1033296348
Name:LEE, NANCY LORRAINE (LCSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:LORRAINE
Last Name:LEE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 SCHLEY AVE
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1472
Mailing Address - Country:US
Mailing Address - Phone:302-430-1685
Mailing Address - Fax:
Practice Address - Street 1:117 SCHLEY AVE
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1472
Practice Address - Country:US
Practice Address - Phone:302-430-1685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00005451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000036950Medicaid
DE1000038250Medicaid
DE1000038250Medicaid