Provider Demographics
NPI:1598068827
Name:STAATS, LEE R (LPC-I)
Entity Type:Individual
Prefix:MR
First Name:LEE
Middle Name:R
Last Name:STAATS
Suffix:
Gender:M
Credentials:LPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 SUMMERHILL RD STE A
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75501-3570
Mailing Address - Country:US
Mailing Address - Phone:903-792-4779
Mailing Address - Fax:903-792-4693
Practice Address - Street 1:2401 SUMMERHILL RD STE A
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75501-3570
Practice Address - Country:US
Practice Address - Phone:903-792-4779
Practice Address - Fax:903-792-4693
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67139101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional