Provider Demographics
NPI:1609065820
Name:LEE, LARRON KEITH (LCMHCS)
Entity Type:Individual
Prefix:MR
First Name:LARRON
Middle Name:KEITH
Last Name:LEE
Suffix:
Gender:M
Credentials:LCMHCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 EAST STREET, PO BOX 1763
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27312-7015
Mailing Address - Country:US
Mailing Address - Phone:984-345-5119
Mailing Address - Fax:984-345-5538
Practice Address - Street 1:50101 GOVERNORS DR STE 280
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-9517
Practice Address - Country:US
Practice Address - Phone:984-345-5119
Practice Address - Fax:984-345-5538
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-24
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCS6675101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health