Provider Demographics
NPI:1568647360
Name:LEE, COURTNEY COLLINS (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:COLLINS
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 1:4 CAMINO CALABASAS
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87506-2113
Mailing Address - Country:US
Mailing Address - Phone:505-699-3538
Mailing Address - Fax:
Practice Address - Street 1:2100 YUCCA ST
Practice Address - Street 2:# G
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-5456
Practice Address - Country:US
Practice Address - Phone:505-467-2439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-31
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0079981101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health