Provider Demographics
NPI:1235523903
Name:MD LEE COUNSELING, PLLC
Entity Type:Organization
Organization Name:MD LEE COUNSELING, PLLC
Other - Org Name:MELISSA D. LEE, LMSW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED CLINICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:D
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-909-9481
Mailing Address - Street 1:1133 S LONG LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48362-3648
Mailing Address - Country:US
Mailing Address - Phone:248-909-9481
Mailing Address - Fax:
Practice Address - Street 1:628 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-1834
Practice Address - Country:US
Practice Address - Phone:248-909-9481
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-20
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010900261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty