Provider Demographics
NPI:1356002349
Name:LEE, SHEKINAH JOY (ALC, NCC)
Entity Type:Individual
Prefix:
First Name:SHEKINAH
Middle Name:JOY
Last Name:LEE
Suffix:
Gender:F
Credentials:ALC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5773 WILLOW LAKE DR
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-4137
Mailing Address - Country:US
Mailing Address - Phone:305-310-0655
Mailing Address - Fax:
Practice Address - Street 1:2100A SOUTHBRIDGE PKWY STE 650
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-1377
Practice Address - Country:US
Practice Address - Phone:205-236-9136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-03
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor