Provider Demographics
NPI:1326284993
Name:LEE, REESE ALSON (LPC, CAC)
Entity Type:Individual
Prefix:MR
First Name:REESE
Middle Name:ALSON
Last Name:LEE
Suffix:
Gender:M
Credentials:LPC, CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1661 HARDSCRABBLE RD
Mailing Address - Street 2:
Mailing Address - City:MUNSON
Mailing Address - State:PA
Mailing Address - Zip Code:16860-9404
Mailing Address - Country:US
Mailing Address - Phone:814-345-6236
Mailing Address - Fax:814-345-6230
Practice Address - Street 1:1661 HARDSCRABBLE RD
Practice Address - Street 2:
Practice Address - City:MUNSON
Practice Address - State:PA
Practice Address - Zip Code:16860-9404
Practice Address - Country:US
Practice Address - Phone:814-345-6236
Practice Address - Fax:814-345-6230
Is Sole Proprietor?:No
Enumeration Date:2009-01-01
Last Update Date:2009-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC001825101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102234351OtherPROMISE