Provider Demographics
NPI:1811574395
Name:SOO-IL LEE MENTAL HEALTH COUNSELING, P.C.
Entity Type:Organization
Organization Name:SOO-IL LEE MENTAL HEALTH COUNSELING, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SOO-IL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:516-395-8706
Mailing Address - Street 1:502 WILLOW LN
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-7020
Mailing Address - Country:US
Mailing Address - Phone:516-395-8706
Mailing Address - Fax:
Practice Address - Street 1:22016 UNION TPKE
Practice Address - Street 2:
Practice Address - City:OAKLAND GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11364-3543
Practice Address - Country:US
Practice Address - Phone:516-395-8706
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty