Provider Demographics
NPI:1629174131
Name:LEE, STEVE ELDON (LMFT)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:ELDON
Last Name:LEE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 MELODY LN
Mailing Address - Street 2:STE. 203
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-5193
Mailing Address - Country:US
Mailing Address - Phone:916-204-8623
Mailing Address - Fax:
Practice Address - Street 1:1110 MELODY LN
Practice Address - Street 2:STE. 203
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-5193
Practice Address - Country:US
Practice Address - Phone:916-204-8623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2009-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 46815106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist