Provider Demographics
NPI:1801380282
Name:LEE, KRISTIN (LAPC)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 CHAMBERLAIN ST SE APT C1
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-1820
Mailing Address - Country:US
Mailing Address - Phone:404-509-3350
Mailing Address - Fax:
Practice Address - Street 1:2262 FAIRBURN RD
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-1162
Practice Address - Country:US
Practice Address - Phone:678-871-7529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-19
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor