Provider Demographics
NPI:1295817914
Name:LEE, SANDRA S (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:S
Last Name:LEE
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 FOXTRAIL DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9086
Mailing Address - Country:US
Mailing Address - Phone:970-541-9590
Mailing Address - Fax:
Practice Address - Street 1:1635 FOXTRAIL DR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-9086
Practice Address - Country:US
Practice Address - Phone:970-541-9590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 251141041C0700X
COCSW.099232171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical