Provider Demographics
NPI:1417554783
Name:SLOAN, LEE MCCOY (LCSW)
Entity Type:Individual
Prefix:MR
First Name:LEE
Middle Name:MCCOY
Last Name:SLOAN
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 1:2400 E COMMERCIAL BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4022
Mailing Address - Country:US
Mailing Address - Phone:754-243-5650
Mailing Address - Fax:
Practice Address - Street 1:2400 E COMMERCIAL BLVD STE 101
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4022
Practice Address - Country:US
Practice Address - Phone:754-243-5650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-08
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW176521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical