Provider Demographics
NPI:1407289523
Name:LEE, JOSEPH R (LCSW)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:R
Last Name:LEE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5433 SHADOWWOOD DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-3516
Mailing Address - Country:US
Mailing Address - Phone:757-478-3989
Mailing Address - Fax:757-233-7299
Practice Address - Street 1:700 BAKER RD STE 108
Practice Address - Street 2:DOVE LANDING PROFESSIONAL BLDG
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-1077
Practice Address - Country:US
Practice Address - Phone:757-460-4477
Practice Address - Fax:757-233-7299
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040066981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical