Provider Demographics
NPI:1326336546
Name:LEE, MICAELA E (LIMHP)
Entity Type:Individual
Prefix:
First Name:MICAELA
Middle Name:E
Last Name:LEE
Suffix:
Gender:F
Credentials:LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16733 WHIPPOORWILL RD
Mailing Address - Street 2:
Mailing Address - City:HONEY CREEK
Mailing Address - State:IA
Mailing Address - Zip Code:51542-4451
Mailing Address - Country:US
Mailing Address - Phone:402-214-3301
Mailing Address - Fax:
Practice Address - Street 1:16733 WHIPPOORWILL RD
Practice Address - Street 2:
Practice Address - City:HONEY CREEK
Practice Address - State:IA
Practice Address - Zip Code:51542-4451
Practice Address - Country:US
Practice Address - Phone:402-214-3301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-21
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9330101YM0800X
IA0937941041C0700X
NE15601041C0700X
NE4598101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical