Provider Demographics
NPI:1427593342
Name:VARON, LEE S (LICSW)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:S
Last Name:VARON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 WALDEN ST
Mailing Address - Street 2:1E
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-3507
Mailing Address - Country:US
Mailing Address - Phone:917-566-4321
Mailing Address - Fax:
Practice Address - Street 1:205 WALDEN ST
Practice Address - Street 2:1E
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-3507
Practice Address - Country:US
Practice Address - Phone:917-566-4321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-01
Last Update Date:2017-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10178911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical