Provider Demographics
NPI:1356689574
Name:LEE, ALEX (MSW)
Entity Type:Individual
Prefix:MR
First Name:ALEX
Middle Name:
Last Name:LEE
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 N ALHAMBRA AVE APT C
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91755-1964
Mailing Address - Country:US
Mailing Address - Phone:626-377-6770
Mailing Address - Fax:
Practice Address - Street 1:1181 BELL ST
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91104-2938
Practice Address - Country:US
Practice Address - Phone:626-377-6770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-23
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA306981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical