Provider Demographics
NPI:1376664516
Name:J.P. LEE, LLC
Entity Type:Organization
Organization Name:J.P. LEE, LLC
Other - Org Name:COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHP
Authorized Official - Phone:308-532-8300
Mailing Address - Street 1:421 N OAK ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-3764
Mailing Address - Country:US
Mailing Address - Phone:308-532-8300
Mailing Address - Fax:308-532-4329
Practice Address - Street 1:421 N OAK ST
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-3764
Practice Address - Country:US
Practice Address - Phone:308-532-8300
Practice Address - Fax:308-532-4329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE398101YA0400X
NEP-521101YA0400X
NE1411101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
6023OtherMIDLANDS
NE85743OtherBCBS
MN068988OtherVALUE OPTIONS
NE85516OtherBCBS
NE10025349500Medicaid