Provider Demographics
NPI:1477057446
Name:LEE, MARY VALERIE (LMHC)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:VALERIE
Last Name:LEE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1062 LAKE SEBRING DR
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-1426
Mailing Address - Country:US
Mailing Address - Phone:863-658-0116
Mailing Address - Fax:
Practice Address - Street 1:1062 LAKE SEBRING DR
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-1426
Practice Address - Country:US
Practice Address - Phone:863-658-0116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11123101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health