Provider Demographics
NPI:1235990821
Name:LEE, ALLYSON ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:ALLYSON
Middle Name:ELIZABETH
Last Name:LEE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ALLYSON
Other - Middle Name:ELIZABETH
Other - Last Name:FINK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2408 SUSANNAH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-1765
Mailing Address - Country:US
Mailing Address - Phone:423-434-6677
Mailing Address - Fax:
Practice Address - Street 1:2408 SUSANNAH ST STE 1
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-1765
Practice Address - Country:US
Practice Address - Phone:423-434-6677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-19
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN87541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical