Provider Demographics
NPI:1598020786
Name:LEE, ELLEN (MSW)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:
Other - Last Name:JOE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17800 WOODRUFF AVE
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-7079
Mailing Address - Country:US
Mailing Address - Phone:562-866-8956
Mailing Address - Fax:562-867-0739
Practice Address - Street 1:17800 WOODRUFF AVE
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-7079
Practice Address - Country:US
Practice Address - Phone:562-866-8956
Practice Address - Fax:562-867-0739
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW808631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical