Provider Demographics
NPI:1780002790
Name:LEE, TERESA (LCSW, LCAS)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:LCSW, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7781 CRYSTAL SPRINGS CIR APT 208
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-6769
Mailing Address - Country:US
Mailing Address - Phone:252-258-1768
Mailing Address - Fax:
Practice Address - Street 1:150 E ARLINGTON BLVD STE E
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5019
Practice Address - Country:US
Practice Address - Phone:252-695-0269
Practice Address - Fax:252-413-0526
Is Sole Proprietor?:No
Enumeration Date:2014-04-07
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health