Provider Demographics
NPI:1508094517
Name:ELAHEE-LEE, LOREE
Entity Type:Individual
Prefix:
First Name:LOREE
Middle Name:
Last Name:ELAHEE-LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11134 LUSCHEK DR
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45241-2434
Mailing Address - Country:US
Mailing Address - Phone:513-827-9273
Mailing Address - Fax:513-818-9960
Practice Address - Street 1:11134 LUSCHEK DR
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45241
Practice Address - Country:US
Practice Address - Phone:513-827-9273
Practice Address - Fax:513-818-9960
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLCDCIII.162670101YA0400X
OH10764363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)