Provider Demographics
NPI:1033413539
Name:LEE, DANA (LPC)
Entity Type:Individual
Prefix:MS
First Name:DANA
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1602 W BUSINESS 380 STE 100
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-3267
Mailing Address - Country:US
Mailing Address - Phone:940-539-0683
Mailing Address - Fax:940-228-0651
Practice Address - Street 1:1602 W BUSINESS 380 STE 100
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-3267
Practice Address - Country:US
Practice Address - Phone:940-539-0683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-27
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14583101YA0400X
TX78130101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8PW076OtherBCBS
TX402786403Medicaid