Provider Demographics
NPI:1356506513
Name:LEE, YONG (LPC)
Entity Type:Individual
Prefix:MR
First Name:YONG
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 WHITE HORSE PIKE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:HADDON HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08035-1739
Mailing Address - Country:US
Mailing Address - Phone:609-314-9719
Mailing Address - Fax:
Practice Address - Street 1:204 WHITE HORSE PIKE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:HADDON HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08035-1739
Practice Address - Country:US
Practice Address - Phone:609-314-9719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-26
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00487600101YM0800X
ORC3542101YM0800X
PAPC007980101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health