Provider Demographics
NPI:1760688626
Name:LEE, KATHY M (LMHC)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:M
Last Name:LEE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6645 VINELAND RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7841
Mailing Address - Country:US
Mailing Address - Phone:407-363-6779
Mailing Address - Fax:407-363-6830
Practice Address - Street 1:6645 VINELAND RD
Practice Address - Street 2:SUITE 250
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7841
Practice Address - Country:US
Practice Address - Phone:407-363-6779
Practice Address - Fax:407-363-6830
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6855101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health