Provider Demographics
NPI:1508895830
Name:DALY, LEE (LCSW)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:
Last Name:DALY
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 1:1016 W CHARTER ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-1002
Mailing Address - Country:US
Mailing Address - Phone:813-812-2837
Mailing Address - Fax:815-331-0680
Practice Address - Street 1:1016 W CHARTER ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-1002
Practice Address - Country:US
Practice Address - Phone:813-812-2837
Practice Address - Fax:815-331-0680
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2023-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW102021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3366697OtherUNITED BEHAVIORAL HEALTH
FLHZ561AMedicaid
FL871062498OtherOPTUM