Provider Demographics
NPI:1437308723
Name:LEE, NANCY W (LMSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:W
Last Name:LEE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7559 263RD ST
Mailing Address - Street 2:HILLSIDE HOSPITAL, WORK SERVICES
Mailing Address - City:GLEN OAKS
Mailing Address - State:NY
Mailing Address - Zip Code:11004-1150
Mailing Address - Country:US
Mailing Address - Phone:718-470-8312
Mailing Address - Fax:718-334-4330
Practice Address - Street 1:7559 263RD ST
Practice Address - Street 2:HILLSIDE HOSPITAL, WORK SERVICES
Practice Address - City:GLEN OAKS
Practice Address - State:NY
Practice Address - Zip Code:11004-1150
Practice Address - Country:US
Practice Address - Phone:718-470-8312
Practice Address - Fax:718-334-4330
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0621161104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY120770OtherNYS DEPARTMENT OF HEALTH SCREEN TRAINING