Provider Demographics
NPI:1578731063
Name:LEE, LINDA LOUISE
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:LOUISE
Last Name:LEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:LOUISE
Other - Last Name:STENNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPC
Mailing Address - Street 1:17171 COUNTY ROAD 150
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MO
Mailing Address - Zip Code:64836-9407
Mailing Address - Country:US
Mailing Address - Phone:417-434-6424
Mailing Address - Fax:
Practice Address - Street 1:1515 HAZEL ST
Practice Address - Street 2:SUITE 201
Practice Address - City:CARTHAGE
Practice Address - State:MO
Practice Address - Zip Code:64836-2850
Practice Address - Country:US
Practice Address - Phone:417-237-0070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-18
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001018368101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional