Provider Demographics
NPI:1134490659
Name:LEE, SANG MEONG (LCPC)
Entity Type:Individual
Prefix:
First Name:SANG MEONG
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16325 S. HARLEM AVENUE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-1688
Mailing Address - Country:US
Mailing Address - Phone:708-429-6999
Mailing Address - Fax:708-429-6909
Practice Address - Street 1:16325 S. HARLEM AVENUE
Practice Address - Street 2:SUITE 200
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-1688
Practice Address - Country:US
Practice Address - Phone:708-429-6999
Practice Address - Fax:708-429-6909
Is Sole Proprietor?:No
Enumeration Date:2012-01-13
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.006884101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional