Provider Demographics
NPI:1306537998
Name:LEE, ANDRANA CONNIE (MSW)
Entity type:Individual
Prefix:
First Name:ANDRANA
Middle Name:CONNIE
Last Name:LEE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 GOOSEDOWN CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-3170
Mailing Address - Country:US
Mailing Address - Phone:803-464-2249
Mailing Address - Fax:
Practice Address - Street 1:1905 J N PEASE PL
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-4557
Practice Address - Country:US
Practice Address - Phone:704-910-0136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical