Provider Demographics
NPI:1568742716
Name:SMITH, LEE ANDERSON JR (MDIV, LCSW)
Entity Type:Individual
Prefix:MR
First Name:LEE
Middle Name:ANDERSON
Last Name:SMITH
Suffix:JR
Gender:M
Credentials:MDIV, LCSW
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Mailing Address - Street 1:222 COLONIAL HOMES DR NW UNIT 2209
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1624
Mailing Address - Country:US
Mailing Address - Phone:678-799-9900
Mailing Address - Fax:678-868-1695
Practice Address - Street 1:1246 CONCORD RD SE STE 203
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-4394
Practice Address - Country:US
Practice Address - Phone:404-491-0299
Practice Address - Fax:678-868-1695
Is Sole Proprietor?:No
Enumeration Date:2011-08-19
Last Update Date:2020-06-04
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Provider Licenses
StateLicense IDTaxonomies
GACSW0048171041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical