Provider Demographics
NPI:1508528274
Name:LEE, STEPHANIE SATTERTHWAITE (LCSW)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:SATTERTHWAITE
Last Name:LEE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2723 HICKORY FORK RD
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23061-4032
Mailing Address - Country:US
Mailing Address - Phone:757-630-2910
Mailing Address - Fax:
Practice Address - Street 1:2723 HICKORY FORK RD
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:VA
Practice Address - Zip Code:23061-4032
Practice Address - Country:US
Practice Address - Phone:757-630-2910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-11
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904012652101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty