Provider Demographics
NPI:1053823302
Name:LEE, SHEKITA HALL (LPC)
Entity Type:Individual
Prefix:
First Name:SHEKITA
Middle Name:HALL
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 1:5376 STONE COVE DR SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-8917
Mailing Address - Country:US
Mailing Address - Phone:404-316-6176
Mailing Address - Fax:
Practice Address - Street 1:415 KING ARNOLD ST
Practice Address - Street 2:
Practice Address - City:HAPEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30354-1647
Practice Address - Country:US
Practice Address - Phone:404-316-6176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-26
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA008527101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional