Provider Demographics
NPI:1174859805
Name:LEE, BRENDA KAY (MS, LPCC)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:KAY
Last Name:LEE
Suffix:
Gender:F
Credentials:MS, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 ARLENE RD SE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-2720
Mailing Address - Country:US
Mailing Address - Phone:505-400-5632
Mailing Address - Fax:
Practice Address - Street 1:1740 ARLENE RD SE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-2720
Practice Address - Country:US
Practice Address - Phone:505-400-5632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-30
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0148021101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health